AccountId: 011433970860
ContactId: f2262d01-1a47-484a-8b79-cf696b39b8ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 387000 ms
Total Talk Time (AGENT): 170868 ms
Total Talk Time (CUSTOMER): 100529 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f2262d01-1a47-484a-8b79-cf696b39b8ce_20250213T16:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank you for calling.
[CUSTOMER][NEUTRAL] Good morning Ms. [PII]. My name is [PII]. I'm calling from Osher LSU Health here in [PII], and I was calling to try to verify eligibility and benefits for a patient that we have that's here, um, being seen in our bone marrow transplant clinic.
[AGENT][POSITIVE] OK, I'm happy to check on benefits today. What is the policy number?
[CUSTOMER][NEUTRAL] I have 769-779.
[AGENT][POSITIVE] All right, thank you. Let me pull that up here.
[CUSTOMER][NEUTRAL] If you don't mind me asking, this, how do you spell your name, babe?
[AGENT][NEUTRAL] Oh, you spell it S [PII]
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][POSITIVE] No problem.
[AGENT][NEUTRAL] OK. And then what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have Ms. [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you so much. So the patient plan is active. The effective date on this is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And to make sure that I do have it according to the card, it's actually a limited medical plan, correct?
[AGENT][NEUTRAL] So, let me see what this patient has with us. One second.
[AGENT][NEUTRAL] OK. So, yeah, this particular plan is a cancer plan.
[CUSTOMER][NEUTRAL] you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So there's like um for this type of plan, um does it have like a deductible or
[AGENT][NEUTRAL] No, it's not gonna have any deductible like anything like that on it. I think it probably is just gonna start to pay like additional coverage. I don't know if she has any sort of major medical or anything. See.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] She does have a primary insurance and.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so this would just be like additional benefits towards any sort of cancer treatment. Um, it looks like.
[AGENT][NEUTRAL] Trying to see, it's an old plan. I'm trying to see what exactly is covered on here, one second.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] I don't, is she gonna be inpatient or do you need like outpatient benefits?
[CUSTOMER][NEUTRAL] Um, I actually only checked her in for just a regular clinic appointment. It'll be outpatient.
[AGENT][NEUTRAL] OK. So it looks like the outpatient, um, well, this is for like hospital or surgical center, is $400 per day.
[CUSTOMER][NEUTRAL] Oh OK, OK, so she doesn't have any outpatient coverage it's all inpatient?
[AGENT][NEUTRAL] Um, yeah, it looks like.
[AGENT][NEUTRAL] and chemotherapy let me see if there's anything for like office visit on here.
[AGENT][NEUTRAL] Yeah, a lot of it is like medical imaging if she had to have like um a follow-up for like diagnostic testing, but I don't see any sort of benefit payment on here, just straight out for office visit.
[CUSTOMER][NEUTRAL] OK, OK, so, right, no, so no out of pocket expense or whatever, it's just a limited medical plan.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Does she have like a maximum out of pocket benefit?
[AGENT][NEUTRAL] Hmm. Well, I mean, there's like a max it would, it's just depending on like what it is for, you know what I mean?
[CUSTOMER][NEUTRAL] OK, OK, OK.
[AGENT][NEUTRAL] Like the way that the schedule benefits breaks down, like it's paying a set amount for like radiation and chemotherapy, the max it would pay is like up to 15,000, but that's just for those specific things, you know, it kind of breaks it down each benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Does that make sense?
[AGENT][NEUTRAL] Did you need me to check on anything else for you today, [PII]?
[CUSTOMER][NEUTRAL] Um, no, ma'am, not at all, sweetie. Would there be a reference number that I may be able to gather for our call?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial in today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][POSITIVE] All right, thank you so very much, Ms. [PII]. I do greatly appreciate it.
[AGENT][POSITIVE] You're welcome have a good day.
[CUSTOMER][POSITIVE] You too thank you ma'am.
[AGENT][NEUTRAL] Bye-bye.