AccountId: 011433970860
ContactId: 18ca7285-4971-4095-b192-264fb0a84db3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 398260 ms
Total Talk Time (AGENT): 120548 ms
Total Talk Time (CUSTOMER): 58894 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/2025/04/25/18ca7285-4971-4095-b192-264fb0a84db3_20250425T15:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATO. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, what was your name again? I'm sorry?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Doctor's Hospital. I need to verify benefits for a patient.
[AGENT][POSITIVE] Of course, I can help you with benefits today. Do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yes, I have 01603031 M as in Mary, L as in Larry, 8.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And then [PII], what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, and what's the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII], last name [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. And so the policy number that you gave me is no longer active, but he does have another policy.
[AGENT][NEUTRAL] And I can give you that policy number as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, go ahead with the policy number.
[AGENT][NEUTRAL] It's 254-496-4.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 254-496-4
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And then is this for an office visit?
[CUSTOMER][NEUTRAL] This is for outpatient hospital, um, patients coming in for a CT scan.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, just one minute. Let me pull up his benefits really quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, this is not a guaranteed payment, it's just a verification of coverage. So it looks like he has an outpatient benefit amount of $1250 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK. And has anything been used?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] And then there is a max on that as well, and that's a maximum of $3000 750 dollars per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] chili sauce.
[AGENT][NEUTRAL] Sorry, he, it looks like he used the outpatient amount twice. I just need to calculate this really quick.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] OK. It looks so.
[AGENT][NEUTRAL] It looks like he has.
[AGENT][NEUTRAL] $866.44 left for the outpatient benefit amount.
[CUSTOMER][NEUTRAL] $866 with? I'm sorry?
[AGENT][NEUTRAL] Yes, $866.44 left.
[CUSTOMER][NEUTRAL] Remaining, OK.
[AGENT][NEUTRAL] Oh, sorry, yes, remaining.
[CUSTOMER][POSITIVE] OK, perfect. And then um if I can get the effective date.
[AGENT][POSITIVE] Yes, of course.
[AGENT][NEUTRAL] So, the effective date is [PII].
[CUSTOMER][NEUTRAL] And then if I can get the first initial to your last name and a reference number if there is one.
[AGENT][NEUTRAL] Yes, so it's H.
[AGENT][NEUTRAL] And then the reference number is going to be my first name, which is [PII], last initial [PII], and then today's date.
[CUSTOMER][POSITIVE] All right perfect thank you so much.
[AGENT][POSITIVE] Yeah, of course. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, that was all for today.
[AGENT][POSITIVE] OK, well, thanks for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] OK, bye.