AccountId: 011433970860
ContactId: 256b4cd0-e322-43a6-ae70-4437b9243845
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165970 ms
Total Talk Time (AGENT): 84002 ms
Total Talk Time (CUSTOMER): 39069 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/256b4cd0-e322-43a6-ae70-4437b9243845_20250620T16:13_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] How you doing? My name is [PII] and I'm calling from the research center of Northern Baltimore trying to get facility benefits for an outpatient procedure.
[AGENT][POSITIVE] Sure, [PII], I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now I need um the policy number, please.
[CUSTOMER][NEUTRAL] 02519567
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active and this is for outpatient benefits.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It is outpatient down at the ambulatory surgical center.
[AGENT][NEUTRAL] OK. Yes, ma'am. Under this policy, we cover up to 2,025 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] You said 2500 is the total you guys will cover?
[AGENT][NEUTRAL] Let me get back to that screen. Um, 2025.
[AGENT][NEUTRAL] 2025.
[CUSTOMER][NEUTRAL] 2500.
[AGENT][NEUTRAL] No, ma'am. Um, 2025.
[AGENT][NEUTRAL] Um, 2.0. Yes, ma'am.
[CUSTOMER][NEUTRAL] 2025.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you guys require an authorization or anything?
[AGENT][NEUTRAL] Um, no, ma'am. Since this is secondary insurance, we go by the primary insurance, um, guidelines, so there's no authorization required.
[CUSTOMER][NEUTRAL] OK, and do you guys require referrals?
[AGENT][NEUTRAL] Um, no, we don't require referrals either.
[CUSTOMER][NEUTRAL] OK, and may I have a reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII], um it's spelled [PII] Last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] No, thank you, [PII], for calling APO. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.