AccountId: 011433970860
ContactId: f77b005f-25d0-42db-a163-ee996e542d40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189539 ms
Total Talk Time (AGENT): 85381 ms
Total Talk Time (CUSTOMER): 49675 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/f77b005f-25d0-42db-a163-ee996e542d40_20250121T16:09_UTC.wav
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[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] I can barely hear you. Your voice sounds like really far away.
[AGENT][NEUTRAL] OK. How about now?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. How can I help you?
[CUSTOMER][NEUTRAL] I need to check benefits and eligibility on a patient.
[AGENT][NEUTRAL] Your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And is this for in office outpatient facility?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Outpatient facility?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. And what's the policy number?
[CUSTOMER][NEUTRAL] 1, no excuse me, 01954452.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I show the policy effective date is [PII]. So the policy is active at this time.
[AGENT][NEUTRAL] And the maximum outpatient benefit is up to $5000 per calendar year, and it actually looks like the inpatient and outpatient benefit is um combined for a maximum of up to $5000 per calendar year.
[AGENT][NEUTRAL] Let me check and see if
[CUSTOMER][NEUTRAL] So this plan is secondary to her Blue Cross Blue Shield. I are um.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] What does it pick up?
[AGENT][NEUTRAL] Deductible co-insurance and or co-pay amounts of covered charges up to $5000 per calendar year.
[CUSTOMER][NEUTRAL] Are we in network?
[AGENT][NEUTRAL] There is no network we're following the primary EOB.
[AGENT][NEUTRAL] So whatever is applied towards those three categories and are covered by this policy, that would be the reimbursed amount up to 5000.
[AGENT][NEUTRAL] Per calendar year.
[CUSTOMER][NEUTRAL] And you said 5000, right?
[AGENT][NEUTRAL] 5000 per calendar year inpatient and outpatient benefit is combined.
[CUSTOMER][NEUTRAL] And there's no author or anything required?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I think that's everything they want me to get. May I have a reference number?
[AGENT][NEUTRAL] Mhm. You'll use my name in today's date as your reference, [PII]. And did you have any other questions, [PII], I can help out with today?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You too thank you.