AccountId: 011433970860
ContactId: d113465e-a784-4eaf-aee8-6f116f45752d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153720 ms
Total Talk Time (AGENT): 105588 ms
Total Talk Time (CUSTOMER): 35592 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/d113465e-a784-4eaf-aee8-6f116f45752d_20250130T19:12_UTC.wav
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[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'm looking to verify patient benefits, please.
[AGENT][POSITIVE] OK yeah I can certainly help with benefits. What's that policy number, please?
[CUSTOMER][NEUTRAL] Policy number I have is 1067765.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, the benefits, this is a secondary or gap insurance, and what it's meant to do is pick up the deductible, co-payment or co-insurance from their major medical, up to $500 for outpatient services, up to $5000 per occasion for inpatient services, and then there's also 4 office visits at $25 each.
[AGENT][NEUTRAL] Um, we will pick up the, the co-payment for the office visits up to 4 per calendar year $25 each. Now, that's just a verification that benefit, not a guarantee of payment, um, and that is a per occasion benefit, uh, that $500 it, um.
[AGENT][NEUTRAL] It's per medical occasion.
[CUSTOMER][NEUTRAL] OK, and that was for outpatient, correct?
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] So $500 per day, basically.
[AGENT][NEUTRAL] Well, no, it's, uh, it's, it's per occasion. So what they will do is uh if you have uh a medical uh occasion let's just say that you went to the to the emergency room for a broken leg, um, the, uh, policy will pay up to $500 for the treatment, either for the facility, the, the, uh, the doctor, um, you know, whatever it is that you needed to have done.
[AGENT][NEUTRAL] And then there's 90 days, uh, and another 90 days if you broke your leg again, and then there'd be another $500. So it's $500 per occasion. So, um, you can have multiple occasions that the, yeah, so that's what that's for.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK, got it. Thank you, Ms. [PII]. Can I have your last name, initial, and a reference number, please?
[AGENT][NEUTRAL] Yes, it's [PII], and we're gonna use that today's date as a reference. Is there anything else at all that I may help with?
[CUSTOMER][POSITIVE] No, that'd be all thank you very much for your help.
[AGENT][POSITIVE] OK, thanks for contacting AP have a good day.