AccountId: 011433970860
ContactId: e579365e-5112-45bc-b995-81274ae0b0fe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194429 ms
Total Talk Time (AGENT): 81222 ms
Total Talk Time (CUSTOMER): 69144 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/e579365e-5112-45bc-b995-81274ae0b0fe_20250603T15:40_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi there, I need to check eligibility please.
[AGENT][NEUTRAL] OK, may I ask who's calling?
[CUSTOMER][NEUTRAL] This is [PII] calling from IT consults and services.
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] It's 02404355 ML 8.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And his date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were just needing benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. Is it for outpatient, inpatient or doctor's office?
[CUSTOMER][NEUTRAL] Well, um, this is apparently something new that he's put on his chart, so, um, and since you don't have a portal I need to know eligibility first, so I guess he's eligible, he's active.
[AGENT][NEUTRAL] He is, yes, sir.
[CUSTOMER][NEUTRAL] OK, and so the only indicator that of what this policy is is called MMED supplement. Is that Medicare supplement or medical supplement?
[AGENT][NEUTRAL] Medical supplement is a gap policy that coordinates with the primary insurance. We only pick up what their primary applies to their deductible copay or co-insurance depending on what type of service they're having.
[CUSTOMER][NEUTRAL] OK, so outpatient, um, I mean, yeah, outpatient primary care visit.
[AGENT][NEUTRAL] OK, is it gonna be place of service 11 or place of service 22?
[CUSTOMER][NEUTRAL] 11
[AGENT][NEUTRAL] And is it just for an office visit itself or services in the office?
[CUSTOMER][NEUTRAL] Office visit itself.
[AGENT][NEUTRAL] OK, office visits are not covered under this policy.
[AGENT][NEUTRAL] Now, it does cover services. It does cover services now if services are done.
[CUSTOMER][NEUTRAL] OK, that's what I need to know.
[CUSTOMER][NEUTRAL] Like lab draw.
[AGENT][NEUTRAL] Right, yes, sir, and any benefits given over the phone is not a guarantee of payment, but if they have services done in the doctor's office, we'll pay up to 250 per calendar day.
[CUSTOMER][NEUTRAL] Uh, OK, alright, so but office visit co-pays and co-insurance are not covered by the policy.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] No, sir.
[CUSTOMER][POSITIVE] OK, all right, that's what I needed. Thank you.
[AGENT][POSITIVE] Thank you, um, [PII] for calling APL. You have a good day.