AccountId: 011433970860
ContactId: 379145c0-bb0a-4482-a5cd-c410a43f5758
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230880 ms
Total Talk Time (AGENT): 98249 ms
Total Talk Time (CUSTOMER): 73685 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/379145c0-bb0a-4482-a5cd-c410a43f5758_20250429T17:16_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm just trying to confirm benefits for a patient for an upcoming procedure.
[AGENT][POSITIVE] OK, I can definitely help you with the benefits. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. I'm with the Ausner facility. Callback number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Let me get back on over to it really fast it is.
[AGENT][POSITIVE] Sure, take your time.
[CUSTOMER][NEUTRAL] Um, I was by their benefits section. I'm so sorry, so their number is 01997050.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Author [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, just his general benefits and his, uh, hospital outpatient benefits.
[AGENT][NEUTRAL] Alright, so for outpatient, the policy will pay up to $7000 per calendar year per person.
[AGENT][NEUTRAL] Well, this is an individual. Hold on one moment.
[CUSTOMER][NEUTRAL] OK, so he has a 7000.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Yeah, I'm checking to see if he's used any of it now, hold on one moment.
[CUSTOMER][NEUTRAL] Versus individual?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] That's just individual.
[AGENT][NEUTRAL] Yes, it's an individual policy. I'm sorry?
[CUSTOMER][POSITIVE] Correct, the 7000.
[CUSTOMER][NEUTRAL] Yes ma'am, that's fine. I heard you. I, I think we might be having a bad connection.
[AGENT][NEUTRAL] OK, did you want me to see if he's used any of the 7000 for this year?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So he has a total of $5,529.96 left for the year. He's used, oops.
[CUSTOMER][NEUTRAL] How much sense?
[AGENT][NEUTRAL] Um, 90 cents.
[CUSTOMER][NEUTRAL] 90 cents. OK, and that's left?
[AGENT][NEUTRAL] Yes, he's only used $1470.04.
[CUSTOMER][NEUTRAL] OK, yes, ma'am.
[CUSTOMER][NEUTRAL] And does he have a copay or a co-insurance, coin insurance?
[AGENT][NEUTRAL] Well, we, we pay towards the copay, deductible and co-insurance of covered charges after primary, so we don't apply them, we help pay them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I understand. All right, thank you.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Can I get your name and a reference number?
[AGENT][NEUTRAL] Sure, my name is [PII]
[CUSTOMER][NEUTRAL] Just your name and a reference number, ma'am.
[AGENT][NEUTRAL] Sure, my name is [PII] First [PII] my [PII] is [PII]. There's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] Yes ma'am, thank you.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.