AccountId: 011433970860
ContactId: d6d10f1b-6d11-4f54-a7e7-00d7b357d2bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160259 ms
Total Talk Time (AGENT): 102439 ms
Total Talk Time (CUSTOMER): 37001 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/d6d10f1b-6d11-4f54-a7e7-00d7b357d2bd_20250326T15:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning, I'm calling for benefits eligibility.
[AGENT][POSITIVE] OK, I'll be glad to help you. Go ahead and give me your name and the member's policy number, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] The policy number is 02416851 M as in Mary, L as in love, and the number 8.
[AGENT][NEUTRAL] Alright, [PII], thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] [PII], that's my direct line.
[AGENT][NEUTRAL] Alrighty, thank you for all that information. Now your patient's name and date of birth today please, ma'am?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Alrighty, thank you for all that information. Looks like.
[AGENT][NEUTRAL] Harrier is a dependent spouse on this medical supplemental plan. They show the original effective date is [PII]. Patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want some type of benefits. Is that correct?
[CUSTOMER][NEUTRAL] Yes, for outpatient. How much the patient has for the gap insurance?
[AGENT][NEUTRAL] All righty, let me get that pulled up. Now, of course, what we are is the medical supplemental plan. So the only thing that we will pick up and pay on is anything that is applied towards patients deductible, co-pay, or co-insurance at their primary insurance carrier for sickness and injury only. Nothing routine here is covered no matter what.
[AGENT][NEUTRAL] Now the outpatient benefit here is gonna be no pre-cert, no deductible, and they have a $750 max benefit payable per calendar day no per calendar year, sorry.
[CUSTOMER][NEUTRAL] Has anything been used?
[AGENT][NEUTRAL] Let's go see.
[AGENT][NEGATIVE] Not for [PII] as of today, no, ma'am, nothing.
[CUSTOMER][NEUTRAL] Thank you, can I get a reference number for this call?
[AGENT][NEUTRAL] Well, we don't give reference number, [PII], but you can use my name in today's date and my name is [PII] spelled [PII] And is that all I can help you with?
[CUSTOMER][POSITIVE] That will be all. Thank you so much. Have a good day.
[AGENT][POSITIVE] Well, you as well, [PII]. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.