AccountId: 011433970860
ContactId: 352fe191-7729-4509-b533-432a634e24d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192919 ms
Total Talk Time (AGENT): 98979 ms
Total Talk Time (CUSTOMER): 59849 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=2.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/352fe191-7729-4509-b533-432a634e24d5_20250404T15:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII], last name initial [PII] and I'm calling to verify benefits for outpatient benefits for this patient coming to an outpatient hospital facility, please.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with that eligibility and benefit area. What is the callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, it's going to be 1861522.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you. And [PII], what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] For [PII], [PII], her policy termed on [PII]. I'm checking to see if they have active coverage under another number.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Give me just one second, I'm checking that for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she does. Can I give you her active policy information?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] My pleasure. As of [PII], [PII]'s active policy number is
[AGENT][NEUTRAL] 258.
[AGENT][NEUTRAL] 3434.
[CUSTOMER][POSITIVE] Thank you so much. Oh my God, thank you.
[AGENT][POSITIVE] My pleasure. And this is a secondary policy to the policyholders Major Medical. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] The, um, what does she have for the outpatient benefit for the year, please? And how much has she accumulated please?
[AGENT][NEUTRAL] I apologize.
[AGENT][NEUTRAL] You did ask for that? I apologize.
[AGENT][NEUTRAL] For outpatient, it is a per calendar day benefit and that amount is $2000 and that is a verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] So that's a per calendar day benefit of $2000.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Perfect. And does that apply to copays as well?
[AGENT][NEUTRAL] Co-pay deductible and co-insurance.
[CUSTOMER][POSITIVE] Thank you so much. Can I get your um ref the reference of the call, or I think it's like your name and the um the date correct?
[AGENT][NEUTRAL] You are right, and my name is [PII]. Anything else I can help you with today?
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] No, that'll be all thank you so much have a great weekend.
[AGENT][POSITIVE] I hope you have a great weekend as well [PII]. Thank you for calling APL. Take care.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.