AccountId: 011433970860
ContactId: 00160dcd-980c-4ea0-ac1d-8955cbd5c918
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194880 ms
Total Talk Time (AGENT): 92201 ms
Total Talk Time (CUSTOMER): 52165 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/00160dcd-980c-4ea0-ac1d-8955cbd5c918_20250501T20:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How may I help?
[AGENT][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Hey, hey, [PII], this is [PII] from Ortho One in [PII] Branch, [PII]. I was trying to verify benefits on a patient and see if she needs an authorization for an outpatient procedure, please.
[AGENT][POSITIVE] OK, Miss [PII], I can help you with benefits. Can you please um give me your callback number just in case the call's dropped I'll be able to call you right back.
[CUSTOMER][NEUTRAL] it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII] [PII] uh policy number is 01838980.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, I do show that she does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And no authorization will be needed because this is a secondary insurance, it's not the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what's her benefits?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] I guarantee of payment she has an.
[AGENT][NEUTRAL] Inpatient benefit amount.
[AGENT][NEUTRAL] Per confinement of $3500 if she goes into the hospital for 18 hours or more.
[AGENT][NEUTRAL] And then she also has an outpatient per occurrence benefit of $200 to go towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, so, um.
[CUSTOMER][NEUTRAL] So it doesn't, you don't have any deductible or anything you pay the $200 towards, towards what like say what she would owe for that, OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes ma'am, um, when you send in the claim you'll need to send the EOB from the primary and with the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that we have that to show what the primary paid and we we base it on what the primary is paid.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] What's the 1st 1st initial of your last name is [PII]?
[AGENT][NEUTRAL] It's A
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, Ms. [PII], I believe that's all I need dear.
[AGENT][POSITIVE] Well, you're very welcome. Thank you, Ms. [PII] for calling. I hope you have a good night. Thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you you too mhm bye bye.
[AGENT][NEUTRAL] All right. Bye-bye, ma'am.