AccountId: 011433970860
ContactId: f0f31de8-ff60-45f3-9542-5b1c2a7317e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180000 ms
Total Talk Time (AGENT): 121691 ms
Total Talk Time (CUSTOMER): 54688 ms
Interruptions: 2
Overall Sentiment: AGENT=2.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/f0f31de8-ff60-45f3-9542-5b1c2a7317e5_20250108T20:51_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. This is uh [PII] with Mississippi Urology. I'm trying to um verify, um, insurance coverage for a patient or benefits and eligibility.
[AGENT][NEUTRAL] Hi, [PII].
[AGENT][POSITIVE] Yes, ma'am, be glad to help you. Go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] It is 00747315.
[AGENT][POSITIVE] All right, [PII], 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.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][POSITIVE] Alrighty, thank you so much, [PII], for all that information. Now what's your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] But it looks like she is the insured on this medical supplemental plan. This show her original effective date is [PII]. She is current and active, but I must step on that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am, she's having an outpatient procedure and she's um she's saying this should pick up.
[CUSTOMER][NEUTRAL] For that.
[AGENT][NEUTRAL] OK, let me see for outpatient, let me get over her benefits. OK, now what we, what we are, of course, is her medical supplemental plan. So as long as it is applied towards her deductible, co-pay or co-insurance for sickness and injury that will be what we would pick up and pay now for her outpatient benefit here, she has a $250 deductible and a $4000 outpatient benefit here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No pre-cert.
[CUSTOMER][NEUTRAL] No preset required, OK, so 250.
[AGENT][NEUTRAL] No, ma'am. So all we need is
[AGENT][NEUTRAL] Uh-huh, go ahead.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] No, go ahead.
[CUSTOMER][NEUTRAL] She she has a $250 co-pay for an outpatient procedure.
[AGENT][NEUTRAL] She has a $250 deductible. That means whatever we, yeah, that she'll have to meet here before we start paying out. Yes ma'am, and that right, that still has to be, uh, when you send the claim in the APL, we need a copy of the bill, of course, and the primary EOB. So as long as it's applied towards your deductible copay or co-insurance at her primary, that is what we'll pick up.
[CUSTOMER][NEGATIVE] Oh, deductible.
[CUSTOMER][NEUTRAL] OK, so she, yeah, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, that's what I needed to know.
[AGENT][POSITIVE] Yes, ma'am. And is that all I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] No ma'am, do I have a call reference number?
[AGENT][NEUTRAL] No, we don't give call reference numbers, [PII], but you can use my name in today's date and my name is [PII], spelled [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Yes, ma'am. You're so welcome and thanks for calling APO and you have a great day.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.