AccountId: 011433970860
ContactId: 21537a94-02a2-459f-a00c-82a0c074612f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264970 ms
Total Talk Time (AGENT): 99833 ms
Total Talk Time (CUSTOMER): 68059 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=3.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/21537a94-02a2-459f-a00c-82a0c074612f_20250407T17:54_UTC.wav
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[CUSTOMER][POSITIVE] Oh yeah, oh yes.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling to verify benefits for a patient.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with the benefits. Can I please get your callback number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, the name of the facility is Ortho Now and the phone number is [PII].
[AGENT][POSITIVE] OK, thank you so much. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII], and the policy number is 02503084ML8.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, I'm here. I'm sorry. The phone glitched out for a minute. I've got it pulled up now though. I apologize. OK, so I, I was just talking and, OK, um, [PII]'s effective date is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. She has a supplemental insurance policy that is billed secondary to the primary. It helps with deductible, co-pay and co-insurance. She has an inpatient benefit amount of $2500 and an outpatient benefit amount of $2500 per calendar year.
[CUSTOMER][NEUTRAL] OK, and has any of that been met?
[AGENT][NEUTRAL] Let me check for you real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Uh, she has used $50 of her outpatient benefit.
[CUSTOMER][NEUTRAL] OK, perfect. And would this policy um cover the urgent care co-pay of her primary?
[AGENT][NEUTRAL] Let me look real quick.
[AGENT][NEUTRAL] If she has urgent care, I believe she does.
[AGENT][NEUTRAL] I'm gonna pull up her policy real quick and double check.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It's gonna be just a minute while the computer pulls it in.
[CUSTOMER][POSITIVE] No worries, take your time.
[AGENT][NEUTRAL] It's trying to pull it in now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Good afternoon Oral. How can I help you?
[AGENT][NEUTRAL] Yes, urgent care facility is a covered outpatient facility.
[CUSTOMER][POSITIVE] Perfect. OK, and can I just have a reference number for this call, please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that'll be all thank you for your help.
[AGENT][POSITIVE] OK, well, you have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye bye.