AccountId: 011433970860
ContactId: dc7e2291-701f-4c1c-8450-32e1e1dc33b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258320 ms
Total Talk Time (AGENT): 148809 ms
Total Talk Time (CUSTOMER): 74553 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/dc7e2291-701f-4c1c-8450-32e1e1dc33b3_20250424T13:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling to check benefits for a patient.
[AGENT][POSITIVE] Alrighty, [PII], I'll be glad to help you. Go ahead and give me a good policy number, please, ma'am.
[CUSTOMER][NEUTRAL] Yes, it's 01839217. M for Mary, L for Larry, number 8.
[AGENT][NEUTRAL] All right, [PII], thank you for that information. Now, what's your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Alrighty. Go ahead and give me that policy number one more time. I'm not pulling that up.
[CUSTOMER][NEUTRAL] Yeah. So it's 01839217 M for Mary, L for Larry, number 8.
[AGENT][NEUTRAL] Alrighty, thank you for that, uh, [PII]. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Alrighty, and what is [PII]'s date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] I'm sorry, what was your question?
[AGENT][NEUTRAL] Date of birth for the patient?
[CUSTOMER][NEUTRAL] Yes, so I wanted to know if the um policy is active and the hospital outpatient, what is the coverage?
[AGENT][NEUTRAL] Outpatient hospitals, and go ahead and give me [PII]'s date of birth again, please, ma'am.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, just wanted to make sure on that. Alright, thank you for all that information, [PII]. Now it looks like [PII] is the insured on this medical supplemental plan here at APL. Now what we are, of course, is her supplemental plan, so the only thing that we will pick.
[AGENT][NEUTRAL] Up and pay on is anything for sickness and injury that is applied towards her deductible, co-pay, or co-insurance at her primary insurance carrier. Now her outpatient benefit here, what is she having done? Do you know [PII]?
[CUSTOMER][NEUTRAL] Well, it's for chemotherapy and injection.
[AGENT][NEUTRAL] Alright, let's see, but of course, I can only take this benefit. I cannot guarantee benefits or coverage over the phone, but for her outpatient benefit here, you said it's for chemotherapy, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yeah, because she does not have a cancer writer. Um, so if it's for a cancer diagnosis, she's not gonna have any benefits here for that, um, particular service if that's all she's being treated for. She does have an outpatient benefit, but if it's, if it's strictly for chemotherapy, she does not have a cancer writer here.
[CUSTOMER][NEUTRAL] OK. And for hospital outpatient, if she gets labs or something done, how much is the benefit?
[AGENT][NEUTRAL] Yes, now that benefit, um, would be a no deductible, no pre-cert, and she has a $500 benefit payable per calendar day for outpatient services.
[CUSTOMER][NEUTRAL] OK, great. OK, that sounds good. And do you have a reference number?
[AGENT][NEUTRAL] OK. All right. Is that all that I can help you with? Is that all that I can help answer for you today?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, yes, thank you. Do you have a reference number?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Uh, no, ma'am, we do not give reference number I, but you can use my name in today's date and my name is [PII]
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. You're so nice. Have a great day.
[AGENT][POSITIVE] Oh, well, thank you very much, [PII], and thank you for calling APO. You have a great day as well. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.