AccountId: 011433970860
ContactId: 0d07d522-1e40-44c4-9c2c-4af6277e7162
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180750 ms
Total Talk Time (AGENT): 84568 ms
Total Talk Time (CUSTOMER): 53926 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/0d07d522-1e40-44c4-9c2c-4af6277e7162_20250312T15:31_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. My name is [PII]. I'm calling from Piedmont Mountainside Hospital, and I needed to get coverage and benefits for a patient that's coming into our facility for outpatient surgery.
[AGENT][POSITIVE] OK, well, I can definitely assist you with the eligibility and benefits um for the outpatient surgery. [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes my direct line is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02576409
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing that the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And you said this is for outpatient surgery?
[CUSTOMER][NEUTRAL] Yes, for the facility.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment, I'm just waiting for the benefits to populate here.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. The surgery in a hospital, hospital outpatient facility, or a free-standing outpatient surgery center, the policy would pay up to $250 per day with a max of 1 day per calendar year.
[AGENT][NEGATIVE] There's also, oh no, this is, this is um outpatient, never mind. I was gonna tell you hospital admission and confinement, but this, I forgot it was outpatient, sorry.
[CUSTOMER][NEUTRAL] Uh, that's OK. Um.
[CUSTOMER][NEUTRAL] OK, so 250 per day, 1 per year, uh, can you tell if they exhausted that one, is it?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yes, ma'am. Hold on one moment.
[AGENT][NEUTRAL] Um, so far he hasn't used any of the benefits for this year.
[CUSTOMER][NEUTRAL] OK, great. OK, can I get initial to your last name and a call reference number is available?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name um and today's date. So that's [PII], first initial to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] Great, thank you so much. You have a great day.
[AGENT][POSITIVE] Thank you, [PII]. You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.