AccountId: 011433970860
ContactId: fa4b235c-6490-49ef-8ed3-f05fef5e4417
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 152570 ms
Total Talk Time (AGENT): 96862 ms
Total Talk Time (CUSTOMER): 54456 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/fa4b235c-6490-49ef-8ed3-f05fef5e4417_20250428T20:47_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] Hi, [PII], good afternoon. My name is [PII]. I'm calling from the Murray Calloway County Hospital, calling to check on eligibility and benefits for a member, please.
[AGENT][POSITIVE] Yes, ma'am, [PII], I will be glad to help you. Go ahead with that policy number, please, ma'am.
[CUSTOMER][NEUTRAL] Um, 02319989.
[AGENT][NEUTRAL] Alrighty, [PII], thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Alrighty [PII], thank you for all that information. Now your patient's name and date of birth today please ma'am.
[CUSTOMER][NEUTRAL] American
[CUSTOMER][NEUTRAL] [PII] and her birth date is [PII].
[AGENT][NEUTRAL] Alrighty, thank you so much, [PII], for all that information. That looks like [PII] is the insured on this medical supplemental plan. I do show her original effective date is [PII] current patient is active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want benefits. Is that correct?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][POSITIVE] Yes, ma'am. What type of benefit are you needing today, [PII]?
[CUSTOMER][NEUTRAL] Uh, [PII]'s scheduled to have an MRI later this week, so as an outpatient, it will be done at the facility.
[AGENT][NEUTRAL] So, uh I.
[AGENT][NEUTRAL] Alrighty. OK, it looks like her effective date is [PII]. Now what we are, of course, is her medical supplemental plan. So the only thing we would pick up and pay on is for sickness and injury, and it has to apply towards her deductible co-pay or co-insurance as her primary insurance carrier. Now her outpatient benefit here, [PII], is going to be a $100 deductible per calendar year.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have
[AGENT][NEUTRAL] No pre-cert, and then she has a $2400 benefit payable per calendar year.
[CUSTOMER][NEUTRAL] 270
[CUSTOMER][NEUTRAL] 219
[AGENT][NEUTRAL] Looks like she has already met that deductible as well, OK?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] OK, alright then, that sounds great [PII].
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] Well, is that all I can help answer for you today, [PII]?
[CUSTOMER][POSITIVE] That is it, thank you very much.
[AGENT][POSITIVE] OK. Well, yes, ma'am, [PII], and thanks for calling APO. You have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.