AccountId: 011433970860
ContactId: d17ec7a6-a2c8-4d89-8ac0-33fab48365f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162929 ms
Total Talk Time (AGENT): 83260 ms
Total Talk Time (CUSTOMER): 59149 ms
Interruptions: 0
Overall Sentiment: AGENT=2.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/d17ec7a6-a2c8-4d89-8ac0-33fab48365f5_20250107T13:56_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. Um, I was calling, we are gonna schedule a patient for a surgery, and, um, I'm showing that the patient has Blue Cross as a primary, and this is a secondary insurance, so I was calling to get the benefits.
[AGENT][POSITIVE] Oh, it would be my pleasure to help you with benefits, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] It is 01262595.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][POSITIVE] Alright, thank you, and it would be my pleasure to help you with those benefits for [PII]. I am showing that her policy is active. Effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a secondary policy to her major medical. And did you say that you were needing outpatient or what type of benefits?
[CUSTOMER][NEUTRAL] Yeah, yeah, oh yeah, outpatient surgical benefits, but, um, yeah, for the, for the physician.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, not a problem. So she does have outpatient coverage up to $5350 per calendar year.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Now there is a $1000 deductible on this policy that has to be met prior to paying that $5350.
[AGENT][NEUTRAL] And that is a verification of coverage and not a guarantee of payment. Of course, at this time, she has not met or uh used any of those benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So it's not like you guys cover what her primary doesn't um cover.
[AGENT][NEUTRAL] Well, once that $1000 deductible on this policy is met, then we do cover the deductible, co-pay or co-insurance of the major medical.
[CUSTOMER][NEUTRAL] OK, so once the um.
[CUSTOMER][NEUTRAL] Once the deductible has been met, um.
[CUSTOMER][NEUTRAL] Covers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Deductible
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK, that is what I needed to know.
[AGENT][POSITIVE] Well, it has been a pleasure to assist you with those benefits. Anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] Nope, that's it, thank you.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.