AccountId: 011433970860
ContactId: 12100e1e-d09b-4040-9635-f172e0593bba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181399 ms
Total Talk Time (AGENT): 76818 ms
Total Talk Time (CUSTOMER): 52744 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/12100e1e-d09b-4040-9635-f172e0593bba_20250620T15:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I needed to verify surgical benefits for a patient.
[AGENT][POSITIVE] Alright. Happy to check on benefits. Do we have their policy number?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] 02584155.
[AGENT][NEUTRAL] Thank you. And then if I can grab your name and a callback number for documentation, please?
[CUSTOMER][NEUTRAL] Yeah my name's [PII]'s [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you. So patient is active. Effective date is gonna be [PII]. We are the members secondary insurance, so this covers deductible, co-pay, co-insurance, the primary doesn't. Is the patient being seen um inpatient or outpatient?
[CUSTOMER][NEUTRAL] It's outpatient surgery.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Y'all don't cover office office visit services, right?
[AGENT][NEUTRAL] Um, most of the time these don't cover the office visit fee, correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, OK, give me just a second, let me pull this policy and see what the outpatient benefit is on here. Sorry, one moment.
[CUSTOMER][NEUTRAL] Yeah, and, and I'm just saying I'm looking for the physician portion, not the ambulatory surgery center portion.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] OK, so it looks like their outpatient benefit max on here is gonna be $3000 and that's for the calendar year.
[CUSTOMER][NEUTRAL] OK, has she met any of that yet?
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Looks like only $59.85 has been used, so quite a bit remaining.
[CUSTOMER][NEUTRAL] OK, but it will cover the physician office, the physician surgery charges?
[AGENT][NEUTRAL] Mhm. Correct, yeah.
[CUSTOMER][NEUTRAL] As well as long as we get them in before the surgery center desk.
[AGENT][POSITIVE] Yeah, yeah, exactly. Yeah.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][NEUTRAL] That's good then thank you no that was it.
[AGENT][POSITIVE] You're, you're welcome. Have a good day, [PII].
[CUSTOMER][POSITIVE] Thanks you too bye bye.
[AGENT][NEUTRAL] Bye-bye.