AccountId: 011433970860
ContactId: ed5ce5cb-252e-4ae8-b4b7-1953db9d3569
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277570 ms
Total Talk Time (AGENT): 146090 ms
Total Talk Time (CUSTOMER): 100508 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/ed5ce5cb-252e-4ae8-b4b7-1953db9d3569_20250514T15:09_UTC.wav
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[AGENT][NEUTRAL] Morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning, ma'am. My name is [PII]. How are you?
[AGENT][NEUTRAL] I'm good, [PII]. How about you?
[CUSTOMER][POSITIVE] Good thank you I'm sorry, how do you spell your name?
[AGENT][NEUTRAL] My name is spelled [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the rest
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] [PII] oh thank you my dear very much. I'm calling because I have a member who's gonna have a procedure done at our um ambulatory facility and I'm trying to see how much they have on the gap.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, be glad to help you, go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] Yes ma'am, I have 01845.
[CUSTOMER][NEUTRAL] 803 M as in Mary 2.
[AGENT][POSITIVE] Alrighty, thank you so much 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].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, OK, thank you for all that information. Now, what is your patient's name and date of birth today, please, ma'am?
[CUSTOMER][NEUTRAL] It would be [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Oh wait, yeah, well, I'm not seeing that person covered under that number. Give me that policy number one more time. Maybe I keyed it in wrong.
[CUSTOMER][NEUTRAL] OK, let me see here, uh 01845803 M as in Mary 2.
[AGENT][NEUTRAL] And your, and your patient's name, what, what's that date of birth again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm. I don't have anybody on under that number, that birth date or name covered under that policy number. So I'll tell you what, I will get over here.
[CUSTOMER][NEUTRAL] OK, and they didn't even provide a card but that's what's on the.
[AGENT][NEUTRAL] And look it up.
[AGENT][NEUTRAL] I'm gonna try to look it up by name. Let's see.
[CUSTOMER][NEUTRAL] 01845.
[CUSTOMER][NEUTRAL] Oh, you know what? Hold on, hold on, 001845.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 809.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] ML, I can't see the last letter though.
[AGENT][NEUTRAL] That's OK. Well, I don't need the letters anyway, but, uh, and, and what was your patient's name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, that, that's the right number. Last number is 9, not 3. Yes.
[AGENT][NEUTRAL] OK, now we got that. OK, looks like [PII] is the insured on this medical supplemental plan. I do show the original effective date is [PII].
[AGENT][NEUTRAL] Patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want outpatient benefits, correct?
[CUSTOMER][NEUTRAL] Yes, for ambulatory.
[AGENT][NEUTRAL] Alright, let me get over there and of course what we are 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 for sickness and injury only at her primary insurance carrier. Now her outpatient benefit here is no deductible, no pre-cert, and she has $1000 payable per calendar year.
[AGENT][NEUTRAL] As of today she's not met any of that burque.
[CUSTOMER][NEUTRAL] OK, so 0 use.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The date and you guys pay only up to $1000.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, so you guys pick up deductibles or copay or car and car insurance.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK my dear, may I please have a reference number for the call?
[AGENT][NEUTRAL] What was that all that I can help you with today?
[CUSTOMER][POSITIVE] Yes ma'am you've been great.
[AGENT][NEUTRAL] Well, yes ma'am, but thank you for that, but we don't give reference numbers, but you can use my name in today's date, OK.
[CUSTOMER][NEUTRAL] Got it and it's [PII] correct?
[AGENT][POSITIVE] That is correct. [PII]
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Oh, yes ma'am and thank you for calling APA. You have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.