AccountId: 011433970860
ContactId: d469af23-5f6a-425f-9641-0d8b57778c27
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293119 ms
Total Talk Time (AGENT): 133534 ms
Total Talk Time (CUSTOMER): 81954 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/d469af23-5f6a-425f-9641-0d8b57778c27_20250623T21:20_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I need to check eligibility for patients insurance.
[AGENT][NEUTRAL] Sure, I can assist you with the eligibility. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] It's Oklahoma cancer and blood specialist.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 02152677.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, Miss [PII]. OK, so it looks like we have a different policy for this number. Let me pull the new information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me know when you're ready and I can give you the correct policy number.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, correct policy number is 02566540.
[AGENT][NEUTRAL] The effective date is January, go ahead.
[CUSTOMER][NEUTRAL] OK, so that's
[CUSTOMER][NEUTRAL] Oh, I was just gonna repeat that 02566540.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, the effective date is [PII]. It is active at the moment and this is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK, so this is secondary to Blue Cross?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Could you tell me uh.
[CUSTOMER][NEUTRAL] What the deductible and the.
[CUSTOMER][NEUTRAL] Uh, if there's deductible and co-insurance and um out of pocket.
[AGENT][NEUTRAL] OK, and um what type of service is being render? Is this like an outpatient facility or is it considered an office?
[CUSTOMER][NEUTRAL] It's an office.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, but the, yeah, the patient's having, um.
[CUSTOMER][NEUTRAL] IV infusion.
[AGENT][NEUTRAL] OK, before I give you any benefits.
[CUSTOMER][NEUTRAL] It's done in office.
[AGENT][NEUTRAL] OK, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see, so we have um.
[AGENT][NEUTRAL] There is a maximum benefit of 3000. Now, let me check.
[AGENT][NEUTRAL] OK, so we do cover um cancer treatment and the subject to the outpatient maximum of 3000.
[CUSTOMER][NEUTRAL] And have they met any of that?
[AGENT][NEUTRAL] I can check. Let's see.
[AGENT][NEUTRAL] OK, uh, let me add this together one moment.
[AGENT][NEUTRAL] As of today, she has used $1,032.37.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what was that total? I'm sorry, 3000?
[CUSTOMER][NEUTRAL] The max.
[AGENT][NEUTRAL] Uh, the maximum 3000 per calendar year, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Does it pay 100% after that?
[CUSTOMER][NEUTRAL] Is met
[AGENT][NEUTRAL] No, because this is not the major medical. This is the secondary. So we have, we pay up to $3000 from her deductibles, co-payment, and co-insurance from the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Alright, and can I get a call reference number please?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name and today's date if you will.
[CUSTOMER][NEUTRAL] OK, uh, tell me what your name was again? I'm sorry.
[AGENT][NEUTRAL] You need a spelling?
[AGENT][NEUTRAL] Sure, that's [PII]. That's [PII] initial [PII].
[CUSTOMER][POSITIVE] OK, all right, thank you so much for checking on that for me, have a good rest of your day thank you bye bye.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. You as well. Have a good afternoon. bye.