AccountId: 011433970860
ContactId: d51df247-827c-4b8f-a81f-9428fe9dab22
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245080 ms
Total Talk Time (AGENT): 131228 ms
Total Talk Time (CUSTOMER): 47300 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/d51df247-827c-4b8f-a81f-9428fe9dab22_20250429T16:29_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling to get benefits for patients gap insurance please.
[AGENT][POSITIVE] OK, I'd be glad to help you. Go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] Yes, my name is [PII], last initial is [PII] Member's policy is 022217100.
[AGENT][POSITIVE] Alrighty [PII], thank you for that information. Now while I'm pulling this up, [PII], go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alrighty, OK, thank you for all that information. Now, what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Alrighty, I think I me play with that. All right, looks like I have it pulled up. OK.
[AGENT][NEUTRAL] No, looks like the original effective date is [PII]. I do show this policy terminated on [PII].
[AGENT][NEUTRAL] 24, so let me go and do some research and make sure she didn't flip to a different number. Let's see.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, it looks like she may have flipped to a different number. Let me write this down too.
[AGENT][NEUTRAL] Or
[AGENT][NEUTRAL] Yeah, she flipped a different number. OK, [PII], let me give you the correct policy number that went into effect on [PII]. It is current and active. It's going to be 025.
[AGENT][NEUTRAL] 49523.
[CUSTOMER][NEUTRAL] 02549523.
[AGENT][NEUTRAL] Yes, ma'am, that is correct. And you did say that you want benefits. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] What type of benefits are you needing today, please, ma'am?
[CUSTOMER][NEUTRAL] So, um she's coming in for outpatient services for a diagnostic mammogram and an ultrasound.
[AGENT][NEUTRAL] All right, let me get over to the screen. OK, now, of course, what we all had is her medical supplemental plan. So the only thing that we would pick up and pay on is anything that is applied towards her deductible, co-pay, or co-insurance at her primary insurance carrier for sickness and.
[AGENT][NEUTRAL] Injury only. Now her benefit here is zero deductible, no pre-start, and she has a $6000 benefit payable per calendar year.
[CUSTOMER][NEUTRAL] OK, perfect. Um, has she used any of that 6000 yet or no?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Looks like she's used as of today $1740 of that benefit.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Is that all that I can help you with today?
[CUSTOMER][POSITIVE] Yes, thank you so much. Is there a reference number for the call?
[AGENT][NEUTRAL] No, we don't give breakfast summer cat, but you can use my name on today's date and my name is [PII] spelled [PII]
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help I appreciate that.
[AGENT][POSITIVE] Oh yes, ma'am. OK, and thanks for calling APO. You have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You as well bye bye.