AccountId: 011433970860
ContactId: d333232a-e722-41ae-88b8-d64de36fa149
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174960 ms
Total Talk Time (AGENT): 66102 ms
Total Talk Time (CUSTOMER): 42249 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/d333232a-e722-41ae-88b8-d64de36fa149_20250505T15:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. This is [PII] with Pris. I am trying to verify a policy for a patient.
[AGENT][POSITIVE] OK, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] 01446436.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, it looks like this policy is effective [PII] currently active, and you need outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, outpatient surgery.
[AGENT][NEUTRAL] Surgery, OK.
[AGENT][NEUTRAL] Not a guarantee of payment, basic outline of the policy.
[AGENT][NEUTRAL] Get that pulled up, one moment.
[AGENT][NEUTRAL] OK, for their plan, they have a $4500 per covered person per calendar year maximum benefit payable.
[AGENT][NEUTRAL] That is subject to a $1000 calendar year deductible.
[CUSTOMER][NEUTRAL] OK, have they met anything towards their deductible?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Uh, it doesn't look like he's met anything yet.
[CUSTOMER][NEUTRAL] OK, and I'm sorry, what was the out of pocket?
[AGENT][NEUTRAL] Um, it, it's a maximum payable. This is a secondary policy, so it's $1000 deductible, then it pays up to $4500.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] After that's met.
[CUSTOMER][NEUTRAL] OK, and you said this is a secondary.
[AGENT][NEUTRAL] Yes, so after primary processes the claim, we'll apply the $1000 calendar deductible and then pay up to $4500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, [PII], is there a reference number for the call?
[AGENT][NEUTRAL] It's just my name, [PII], first initial to last name, [PII], and today's date. And anything else I can help with today, [PII]?
[CUSTOMER][POSITIVE] No, that's all. Thank you very much. I hope you have a good rest of your day.
[AGENT][POSITIVE] Thank you for calling APL. I hope you do too.
[CUSTOMER][NEUTRAL] All right, bye.