AccountId: 011433970860
ContactId: ef658606-c82b-4c11-b98f-7ede34ddbf65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157339 ms
Total Talk Time (AGENT): 61570 ms
Total Talk Time (CUSTOMER): 87123 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/ef658606-c82b-4c11-b98f-7ede34ddbf65_20250312T17:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, good afternoon. My name is [PII], and I'm calling from Doctor [PII]'s office, and I'm calling as a courtesy to the patient. Um, uh, she's having a procedure done in the office. She has Aetna as a primary and, um, she's asking us to file it to you guys as a secondary, and I just wanted to know, um, if it would be covered if I gave you the codes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, if it would be covered and with her primary insurance she has um a deductible and co-insurance and I wanted to know um how that would work with you guys, you know, would you pick that up?
[AGENT][NEUTRAL] OK, yeah, let's take a look. What's the policy number, [PII]?
[CUSTOMER][NEUTRAL] It is 02477074.
[AGENT][NEUTRAL] All right. And do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII], no extension.
[AGENT][NEUTRAL] Thank you. And then can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So the patient plan is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is their secondary insurance, so it does pick up deductible, co-pay, and co-insurance that the primary does not. Is it gonna be an outpatient or inpatient, uh, service?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Actually it's gonna be done in the office, the specialist office, so I, I guess outpatient.
[AGENT][NEUTRAL] OK, so their outpatient benefit max um on their plan is 15,000 for the covered year for all covered persons.
[CUSTOMER][NEUTRAL] Oh, OK, OK, you said 15,000 max?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, alright, that sounds good. So we'll file it first to the primary and then we'll send it through a claim, right? With the primaries EOB. OK, alright, thank you so much, dear. Can I get a reference number please?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm. Absolutely.
[AGENT][NEUTRAL] Absolutely, [PII]. So that's gonna be my name with my last initial and then today's date. My name again is [PII], which is [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and today's date and time right you said?
[AGENT][NEUTRAL] Mhm, yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you, thank you so much. I really appreciate your help. You have a great rest of the day.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] OK bye bye.