AccountId: 011433970860
ContactId: 104e475a-5ca0-4c2f-86e4-d7ba786eea08
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277119 ms
Total Talk Time (AGENT): 119060 ms
Total Talk Time (CUSTOMER): 84182 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/104e475a-5ca0-4c2f-86e4-d7ba786eea08_20250321T17:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office. Could you please help me eligibility and benefits? How are you doing today?
[AGENT][POSITIVE] I'm doing good, Ms. [PII]. I can help you with eligibility and benefits. Uh, can I please get your callback number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient first name is [PII].
[CUSTOMER][NEUTRAL] [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is, just one moment. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 02598062.
[AGENT][NEUTRAL] OK, and then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Columbia Endoscopy Center.
[CUSTOMER][NEUTRAL] So it is, just one moment.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It is Columbia Gastroenterology Associate.
[AGENT][POSITIVE] Thank you I appreciate you giving me that information.
[AGENT][NEUTRAL] All right, I've got the insured pulled up now and she does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. She has a limited benefit hospital indemnity plan. Uh, if she goes into the hospital, she.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As um a benefit amount one day per calendar year of $500.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then she has 30 days per calendar year for confinement for 18 hours or more that pays $50.
[AGENT][NEUTRAL] She also has um outpatient.
[CUSTOMER][NEUTRAL] OK. May I know uh
[AGENT][NEUTRAL] Yes, go ahead.
[CUSTOMER][NEUTRAL] OK. Uh, could you please help me with deductible amount and out of pocket amount?
[AGENT][NEUTRAL] OK, let me see if she has any deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For individual benefits.
[AGENT][NEUTRAL] I do not see that she has a deductible or out of pocket amount.
[CUSTOMER][NEUTRAL] OK, there is any coinsurance or copay?
[AGENT][NEUTRAL] No, ma'am, not on this policy.
[CUSTOMER][NEUTRAL] OK. Uh, may I know authorization is required for this?
[AGENT][NEUTRAL] Uh, let me check real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That may be possible um through benefits and a card, uh, to make sure that the provider is a provider that is in network.
[AGENT][NEUTRAL] And I can transfer you on over to multi plan so that you can check with them as far as um being a provider that's a network.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna be a brief hold, yeah, yes, it's T O R Y.
[CUSTOMER][NEUTRAL] Uh, could you please spell that again?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Could you please help me call reference number?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for providing me the information. Have a great day.
[AGENT][POSITIVE] You too, Ms. [PII]. You have a good weekend and thanks for calling APL. It's gonna be a brief hold while I transfer you over.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For questions about your privacy choices.