AccountId: 011433970860
ContactId: 2774cb18-43d3-443f-be7f-c830c87bfad9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157179 ms
Total Talk Time (AGENT): 74159 ms
Total Talk Time (CUSTOMER): 73288 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/2774cb18-43d3-443f-be7f-c830c87bfad9_20250606T18:59_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, my name is [PII] calling from my provider's office for benefits and eligibility.
[AGENT][NEUTRAL] OK, well, I can verify benefits and eligibility for you. And you say your name is, um, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and Ms. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] OK, I have uh 02513186 M as in mom.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] OK, I'm showing her effective date is [PII]. She is active on the policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what benefits are needing for this patient?
[CUSTOMER][NEUTRAL] He has an um uh a procedure, uh, we had an ambulatory facility. It's um an eye surgery and with his primary insurance he has a copay. Do you guys cover, uh, his co-pay?
[AGENT][NEUTRAL] OK. Uh, with this policy is secondary, we help with primary insurance deductible, co-pay or co-insurance. Uh, not a guarantee of payment, just a verification of coverage for outpatient, the max we pay is up to $3000 per calendar day.
[CUSTOMER][NEUTRAL] OK, even though we are, we are a non hospital based provider free standing facility.
[AGENT][NEUTRAL] Well, it's an outpatient facility that's uh covered as outpatient under the plan.
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][NEUTRAL] OK, any accumulations of today?
[AGENT][POSITIVE] It's a per day benefit.
[CUSTOMER][NEUTRAL] Oh, per day? Oh.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Great, OK, perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, and you say your name was?
[AGENT][NEUTRAL] [PII] last initial [PII]
[CUSTOMER][NEUTRAL] OK, any call reference?
[AGENT][NEUTRAL] Uh, you may use my name at today's date.
[CUSTOMER][NEUTRAL] Oh sorry, and the claim goes to what address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect thank you so much.
[AGENT][POSITIVE] Oh you're welcome. Thanks for calling APL. Have a great day and weekend.
[CUSTOMER][NEUTRAL] Mm bye bye.
[CUSTOMER][NEUTRAL] You too bye bye.