AccountId: 011433970860
ContactId: fadd1e64-9ff7-45bf-8aa6-a5570dc1f2c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 159380 ms
Total Talk Time (AGENT): 66521 ms
Total Talk Time (CUSTOMER): 65141 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/fadd1e64-9ff7-45bf-8aa6-a5570dc1f2c2_20250605T19:55_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, I'm calling to verify benefits and eligibility on the patient.
[AGENT][NEUTRAL] OK. Happy to check benefits and eligibility. What is the policy number?
[CUSTOMER][NEUTRAL] 01303310
[AGENT][NEUTRAL] Thank you. And then for documentation, can I.
[CUSTOMER][NEUTRAL] Is it S A R A?
[AGENT][NEUTRAL] Uh, no, I have an H at the end.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] An H. Thank you.
[AGENT][NEUTRAL] Yep, and then if I could just get your name and a callback number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII], and it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. What is the patient name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII], [PII].
[AGENT][NEUTRAL] Thank you. So the patient is active. Effective date is [PII].
[CUSTOMER][NEUTRAL] Is there like a plan number or?
[AGENT][NEUTRAL] Um, I mean, the number that you gave me is their policy number. Are you looking for like a group number or?
[CUSTOMER][NEUTRAL] Um, well, is this a Medicare supplement or is it just a secondary insurance?
[AGENT][NEUTRAL] So we don't have the insured like if they have another primary. This is a limited benefit plan, hospital indemnity.
[CUSTOMER][NEUTRAL] Oh, OK, so this is a primary insurance. OK, all right, uh, well, the patients come in to have a breast ultrasound?
[AGENT][NEUTRAL] OK OK
[CUSTOMER][NEUTRAL] So what would the benefits be for that?
[AGENT][NEUTRAL] So, their wellness diagnostic benefit on their member plan is $250 excuse me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Per test
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if there's any sort of, uh, go ahead, I'm sorry.
[CUSTOMER][NEGATIVE] So, no.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, no maximum for that or?
[AGENT][NEUTRAL] Uh, that's the max it's gonna pay is 250 straight. Like it's not a percentage or anything like that, it's just gonna pay $250 towards it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Any sort of office
[CUSTOMER][NEUTRAL] Is there any prior authorization or anything like that needed?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, perfect. Is there a reference number for this call?
[AGENT][NEUTRAL] That is my name on today's date.
[CUSTOMER][POSITIVE] Thank you so much. I appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. Take care.
[CUSTOMER][POSITIVE] Thank you, you too, bye.