AccountId: 011433970860
ContactId: cfc5c7c1-bec9-4dd5-84f1-afeb423ab257
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 138979 ms
Total Talk Time (AGENT): 72940 ms
Total Talk Time (CUSTOMER): 60613 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/cfc5c7c1-bec9-4dd5-84f1-afeb423ab257_20250414T15:59_UTC.wav
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[AGENT][NEUTRAL] Contacting APO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling you from Gastro Health. I have a patient here that I have a question if you can help me.
[AGENT][NEUTRAL] I can certainly do that. Um, [PII], what's that policy number we're looking at today?
[CUSTOMER][NEUTRAL] For outpatient, it's 01480416 uh M like Mary L like love.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] 8. OK, that's fine. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Her name is [PII] [PII].
[AGENT][POSITIVE] I appreciate that. I just need a callback number please and you know that we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh, [PII], what is the question that I can help with?
[CUSTOMER][NEUTRAL] OK, so she's having, OK, she's having an endoscopy.
[CUSTOMER][NEUTRAL] Um, a gastroscopy, that's what it is, an upper endoscopy, um, she has UnitedHealthcare as her primary, which she has not met her deductible.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So do you guys cover the deductible base or just the uh co-insurance base?
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] OK, so what we do is we'll pick up the deductible co-payment or co-insurance for in and out of hospital settings. So, um, we do pick up the co-pay, we do pick up the deductible and co-insurance, but only in, in and out of hospital settings. So if um gastrohealth
[CUSTOMER][NEUTRAL] Yeah, she's going in an ambulatory center.
[AGENT][NEUTRAL] That's perfect. OK, so in this particular case, we would certainly pick up that co-payment. We pick up a maximum of $500 per calendar day. Um, that's just a verification benefits, it's not a guarantee of payment, but yes, that is what this policy is meant to do.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So they do pick up the call, OK, because some policies the patient has to meet first the uh deductible and then they pick up. So you do pick up even if the patient hasn't met the deductible.
[AGENT][POSITIVE] That's absolutely what we're here for is, is to pick up that, that amount um when they haven't, when they haven't paid their deductible through their primary insurance. That's what we do. That's what they, the gap in, yeah, that's what the gap insurance does. So that's exactly what we're here for.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, can I have a reference number to this call, please?
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We'll use that in today's date as a reference. Is there anything else at all, [PII], that I can help with?
[CUSTOMER][POSITIVE] No. That's it thank you.
[AGENT][POSITIVE] OK, thanks for contacting API.