AccountId: 011433970860
ContactId: d99682bd-1339-4bf0-88ae-edbed71ca5bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250570 ms
Total Talk Time (AGENT): 95417 ms
Total Talk Time (CUSTOMER): 54686 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/d99682bd-1339-4bf0-88ae-edbed71ca5bc_20250527T14:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII].
[CUSTOMER][NEUTRAL] Hi Ms. [PII], this is [PII] from Memorial Preservice department. I was calling to, um, verify um benefits and eligibility on a patient please if you don't mind.
[AGENT][POSITIVE] I can help you with benefits and eligibility. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I have 02563925.
[AGENT][NEUTRAL] Let me look that up for you.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes, that is [PII] [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] OK, I'm showing this policy is active with an effective date of [PII]. It is a Medlink policy, meaning that it is a secondary gap insurance. So whenever filing for a claim, we will need the primary EOB or explanation of benefits um when filing for this claim, for a claim through this one.
[AGENT][NEUTRAL] And what, what kind of benefits were you looking at?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For outpatient procedure?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We pull it up.
[AGENT][NEUTRAL] I do want to remind you that this is an explanation of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I show an outpatient benefit maximum of up to $500 per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is for sickness a sickness or accident for this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For sickening or for accident?
[AGENT][NEUTRAL] Is there any
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] So if she's having a um outpatient procedure.
[CUSTOMER][NEUTRAL] Would we be able to use this one too?
[AGENT][NEUTRAL] If the primary insurance covers part of it and it's under uh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's, it's a procedure covered under this policy, then it should be able to pick up what the primary can't up to $500.
[CUSTOMER][NEUTRAL] OK, OK. Um, may I have, um, the first letter of your last name and a reference number, please, if you don't mind?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, we don't have reference numbers, but you can use my name and last initial, so [PII] and today's date.
[CUSTOMER][POSITIVE] OK. Thank you very much and I appreciate your help.
[AGENT][NEUTRAL] Mm. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that'll be all. Thank you so much appreciate it.
[AGENT][POSITIVE] Great. Thank you for calling APL Liberty. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.