AccountId: 011433970860
ContactId: 08f40a01-1e83-4d0d-ba2b-963cb68b0135
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215429 ms
Total Talk Time (AGENT): 93015 ms
Total Talk Time (CUSTOMER): 84132 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/08f40a01-1e83-4d0d-ba2b-963cb68b0135_20250509T14:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Surgery Center of Coral Springs. I was calling to make sure, uh, to check patient benefits for a procedure they're having at our facility.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with benefits for patients. May I please get your call back number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, it's [PII]. Um, their policy number, oh, their date of birth is [PII]. The policy number is 02607243.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us. The effective date of the policy is [PII], and this is just to verify her benefits. It's not a guarantee of payment. She has a supplemental insurance policy with us. It's billed secondary to the primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] The policy does help with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And she has an inpatient benefit amount per calendar year of $5000.
[AGENT][NEUTRAL] And she also has an outpatient per calendar day benefit of $500.
[AGENT][NEUTRAL] To help with the
[CUSTOMER][NEUTRAL] So, so you all only will cover, so you all will only cover $500 of the procedure cost?
[AGENT][NEUTRAL] Per day.
[CUSTOMER][NEUTRAL] OK, because she's having a procedure and um.
[CUSTOMER][NEUTRAL] She's telling us that you all said you all will cover it because it's for uh it's at our outpatient facility which is an ambulatory surgical center.
[AGENT][NEUTRAL] Yes. And we don't cover the procedure. We actually only cover deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Oh, OK. So the procedure itself is $3000. So you all will only cover 500?
[AGENT][NEUTRAL] $500 per calendar day for deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Per calendar date.
[CUSTOMER][NEUTRAL] OK, only 500 per calendar day and um.
[CUSTOMER][NEUTRAL] That's all I needed to know what's your name and a reference number?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes, my name is [PII] and you can use my name and today's date for your reference.
[CUSTOMER][NEUTRAL] Um, can I get the initials of your last name?
[AGENT][NEUTRAL] Yes, ma'am. It's A.
[CUSTOMER][POSITIVE] OK. Thank you, [PII].
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that's all thank you.
[AGENT][POSITIVE] OK, well you have a wonderful weekend and thank you for calling APL ma'am bye bye.
[CUSTOMER][NEUTRAL] All right, bye.