AccountId: 011433970860
ContactId: 487d5678-057a-46e3-ad3b-c3ea78c4bfec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 135139 ms
Total Talk Time (AGENT): 64349 ms
Total Talk Time (CUSTOMER): 61659 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/487d5678-057a-46e3-ad3b-c3ea78c4bfec_20250304T14:22_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] Hello, [PII]. My name is [PII]. I'm calling from Orthopedic Medical Group. Surgery Center and I was trying to verify benefits of one of our patients.
[AGENT][POSITIVE] OK, I'll be more than happy to assist you with the benefits, um, in terms of, um, if it's active or not or actual coverage.
[AGENT][NEUTRAL] Or both?
[CUSTOMER][NEUTRAL] Uh, both.
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] [PII] is our telephone number. And the policy number is 2479243.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [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].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, benefits, the patient is going to have, um, outpatient surgery in an ambulatory surgery center.
[AGENT][NEUTRAL] OK. So the benefits are up to $500 per calendar day.
[CUSTOMER][NEUTRAL] OK, so that's the only benefit that the patient has.
[AGENT][NEUTRAL] Right, for outpatient um benefits, that's the max, um $500 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. And the, the claims are being submitted by the patient or by the mm provider?
[AGENT][NEUTRAL] Um, it's supposed to be by the provider, but it's, um, yeah, it's usually the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] But the member can file it also. You're welcome. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Yes, if you could uh give me what will be the reference number for our conversation.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] My name
[CUSTOMER][POSITIVE] [PII]. Thank you very much, [PII]. Thank you. Enjoy your day.
[AGENT][POSITIVE] You're welcome and you also thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.