AccountId: 011433970860
ContactId: cbfdf5e6-5a61-4a95-bdef-63c3c146f311
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168979 ms
Total Talk Time (AGENT): 56607 ms
Total Talk Time (CUSTOMER): 88496 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/cbfdf5e6-5a61-4a95-bdef-63c3c146f311_20250623T16:45_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you? My name is [PII] The first initial of my last name is [PII]. And may I please have the first initial of your last name?
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Thank you. I'm calling from a provider's office. I am calling for eligibility and benefits, please.
[AGENT][POSITIVE] OK, [PII], I can help you with eligibility and benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what's the policy number for that patient?
[CUSTOMER][NEUTRAL] Policy number is 01702711.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] I show her policy is active and effective [PII], and is this for outpatient benefits?
[CUSTOMER][NEUTRAL] This is gonna be for uh and um.
[CUSTOMER][NEUTRAL] In network.
[CUSTOMER][NEUTRAL] It's yeah, it's gonna be, what's it called? Outpatient, yes, I'm sorry.
[AGENT][NEUTRAL] OK. Um, this is not a
[CUSTOMER][NEUTRAL] It's Monday, it's Monday.
[AGENT][POSITIVE] Oh, I totally understand.
[CUSTOMER][NEUTRAL] It's Monday. Forgive me. It's Monday. It's one of those days.
[AGENT][NEUTRAL] Sure is
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, not a guarantee of payment basic outline of the policy. Uh, this is a secondary policy, so it's gonna pick up after primary processes the claim. Um, outpatient benefits are gonna pay $4000 per calendar year. There's no deductible.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, OK, so let me see if I have this da da da da. I don't know who wrote these notes, a different representatives, so there is no because they have it down here as deductible as $5000. So there is no $5000. There is no deductible. Oh no, I'm so sorry, forgive me once again, that that's, that's the primary insurance. I'm sorry. So the secondary is saying is, um, it covers the, that covers the co-pay and deductible and co-insurance, is that correct?
[AGENT][NEUTRAL] There is
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's 4000 per calendar year out of that 4000, may I just ask what has been the accumulation for it been met?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I have met
[AGENT][NEUTRAL] Uh, it looks like all she's used so far this year is $99.83.
[CUSTOMER][POSITIVE] Wonderful. Alright, [PII], if you wouldn't mind, can I just get a reference number for this call?
[AGENT][NEUTRAL] Uh, reference number is my name, [PII], first initial to last name [PII], and today's date.
[CUSTOMER][POSITIVE] Mhm. Thank you so much, [PII]. Have a great day.
[AGENT][POSITIVE] Thanks for calling APL you as well. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.