AccountId: 011433970860
ContactId: 2a525cb4-e3a9-4aca-9c75-58d1315a6ca8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154130 ms
Total Talk Time (AGENT): 78493 ms
Total Talk Time (CUSTOMER): 66678 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/2a525cb4-e3a9-4aca-9c75-58d1315a6ca8_20250127T15:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling from um Aventura Medical Tower Surgery Center. I have a patient that's gonna be having surgery here next Monday. I was wondering if you could help me with her benefits. I have a couple of questions.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] My name is [PII]. Call back number is [PII]. I'm I'm sorry, [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] 01530968 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Date of birth [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] and the policy is still active. And you said this is for an outpatient surgery center?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, for outpatient services, we cover up to $1250 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim and the full 1250 is available because she hasn't used any benefits so far this year.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Got it. My question is, um, this 1250, this is her total amount for anything, even like specialist offices, or is this specific to outpatient?
[AGENT][NEUTRAL] OK, yeah, this is specific to outpatient services because actually under her policy um office visits and services provided in office is not covered.
[CUSTOMER][NEUTRAL] Got it. So this amount, the 1250 only goes towards outpatient procedure.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Perfect. OK.
[CUSTOMER][NEUTRAL] And you said your name was [PII] correct?
[AGENT][NEUTRAL] Yes, that's correct. Um, is there anything else that, mhm.
[CUSTOMER][NEUTRAL] And can I get a
[CUSTOMER][NEUTRAL] No, just a reference number for this call, please.
[AGENT][NEUTRAL] Sure. For the reference number, you can use my name and today's date and um my last initial is [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect. Thank you so much for your help, Ebe. You have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling ITL. Mm bye.
[CUSTOMER][NEUTRAL] Bye bye.