AccountId: 011433970860
ContactId: 35e98ea8-ca51-4652-bdc0-ac8a2049d06f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179839 ms
Total Talk Time (AGENT): 77846 ms
Total Talk Time (CUSTOMER): 45758 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/35e98ea8-ca51-4652-bdc0-ac8a2049d06f_20250102T15:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Sports and Orthopedic Center.
[CUSTOMER][NEUTRAL] This is to confirm the benefits for specialist office visit.
[AGENT][POSITIVE] OK, I'm happy to check on benefits for you today. What's the patient's policy number?
[CUSTOMER][NEUTRAL] 01936999
[CUSTOMER][NEUTRAL] 7 M as in Mary. L as in Lima 8.
[AGENT][NEUTRAL] Thank you. And may I please have your first name and a callback number?
[CUSTOMER][NEUTRAL] [PII]. My name is [PII].
[AGENT][NEUTRAL] Thank you for that, [PII]. And then what's the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] All right, thank you. One moment.
[AGENT][NEUTRAL] Right. So it looks like the patient does have an active plan effective date [PII]. It is a different policy number. Do you need that?
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] The active policy is 01988421.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We are the secondary insurance, so this will cover deductible, co-pay, co-insurance. The primary does not. The outpatient benefit max for the calendar year is $5000. That is verification of benefits, not guarantee of payment.
[CUSTOMER][NEUTRAL] Uh, out of 5000, how much is remaining?
[AGENT][NEUTRAL] Uh, the full amount remaining.
[CUSTOMER][NEUTRAL] And this will cover.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, can you please repeat the benefit again? I missed it.
[AGENT][NEUTRAL] Uh, we are the secondary insurance, so this will cover deductible, co-pay, co-insurance. The primary does not.
[CUSTOMER][NEUTRAL] OK. So since the primary is you would see, uh, so it will cover or co-pay?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I have the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial and then today's date. My name again is [PII] spelled [PII] The last initial to my name is [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Mhm. You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] OK, thank you. Bye-bye.
[AGENT][NEUTRAL] Hm.