AccountId: 011433970860
ContactId: 22e33cc7-4de9-4f1c-9c25-6f88661e2767
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163880 ms
Total Talk Time (AGENT): 81664 ms
Total Talk Time (CUSTOMER): 46240 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/22e33cc7-4de9-4f1c-9c25-6f88661e2767_20250513T18:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi sir, uh, my name is [PII]. I'm calling from Montana Medical Center, and I'm trying to verify the benefits for a patient.
[AGENT][POSITIVE] OK, I'm happy to check on benefits. What's the policy number?
[CUSTOMER][NEUTRAL] It's 02598409.
[AGENT][POSITIVE] All right, thank you so much. Let me pull this up. One moment.
[AGENT][NEUTRAL] And if I could get patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], that's [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date on here is going to be [PII]. We are the members secondary insurance, so this will cover deductible, co-pay, co-insurance. The primary does not.
[CUSTOMER][NEUTRAL] Deductibles, copay and coinsurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And how much is it that it covers?
[AGENT][NEUTRAL] Uh, are we looking for the outpatient or inpatient or both?
[CUSTOMER][NEUTRAL] Uh, for, for both.
[AGENT][NEUTRAL] So the member plan and patient benefit max for the calendar year is going to be 2500.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And for outpatient, it looks like it is 1250.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Have they met any of that amount?
[AGENT][NEUTRAL] Alright, so let's see.
[AGENT][NEUTRAL] They have used some of it. Give me just one moment and I'll give you the remaining balance.
[AGENT][NEUTRAL] Right, so it looks like they've used $200 towards the calendar year balance of outpatient, so they have $1050 remaining. They have the full inpatient balance remaining.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Thank you so much, sir. May I have a reference number for the call?
[AGENT][NEUTRAL] Yeah, absolutely. Call references my name with my last initial, then today's date. My name again is [PII], that's [PII] Last initial is [PII], and then today's date.
[CUSTOMER][POSITIVE] [PII] on today's day. Thank you so much. Have a good day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Right