AccountId: 011433970860
ContactId: fe8e38c8-15c9-4480-b741-2dde505fcb43
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 133520 ms
Total Talk Time (AGENT): 59587 ms
Total Talk Time (CUSTOMER): 66787 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/fe8e38c8-15c9-4480-b741-2dde505fcb43_20250114T15:54_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I am needing benefits on this particular patient's plan.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Sure, it is [PII].
[AGENT][NEUTRAL] Thank you, the policy number?
[CUSTOMER][NEUTRAL] It's 218-0309.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth that you're requiring eligibility for today?
[CUSTOMER][NEUTRAL] Sure, it is [PII], [PII].
[AGENT][NEUTRAL] I apologize. What was your name?
[CUSTOMER][NEUTRAL] Sure. My name is [PII].
[AGENT][NEUTRAL] To you, what benefits are you inquiring about inpatient, outpatient, office visits?
[CUSTOMER][NEUTRAL] Outpatient hospital.
[AGENT][NEUTRAL] This policy has been active since [PII] and is currently active. The member has outpatient benefits of $6000 per calendar year, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Got you. Um, and has she used any of this yet?
[AGENT][NEUTRAL] She has not utilized any of her benefits that rolled over in [PII].
[CUSTOMER][NEUTRAL] Got you, um, so from here exactly what that means is whatever we bill her primary, the allied benefits will go to the secondary, correct?
[AGENT][NEUTRAL] Yes, as long as something went towards deductible, co-pay and co-insurance and the services are covered under the policy, then we will make a payment but you will have to send in that ELB from the primary once you receive it along with the claim.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm, mhm. And she would have to meet her deductible of the Allied?
[AGENT][NEUTRAL] No, this is why she have that policy for us to help her meet the deductible. This is a gap insurance.
[CUSTOMER][NEUTRAL] Oh, I see. Got you, meet that deductible. Gotcha. OK, wonderful. That's what I needed to know. Um, can I have a reference number or do I just use your name?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] My name in today's date to you because we don't provide reference numbers.
[CUSTOMER][POSITIVE] Perfect. All right. Well, thank you so much for your help. I do appreciate it.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a great day.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] Bye.