AccountId: 011433970860
ContactId: 4a510bd8-1c26-4fbf-bdfa-b4ad45e092b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 145399 ms
Total Talk Time (AGENT): 69483 ms
Total Talk Time (CUSTOMER): 56629 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/4a510bd8-1c26-4fbf-bdfa-b4ad45e092b3_20250307T20:43_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII] I'm calling from a provider's facility looking to verify the, uh, eligibility and benefits for a member's gap policy.
[AGENT][POSITIVE] OK, sure. I can assist you with eligibility and benefits. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, that'll be [PII].
[AGENT][NEUTRAL] Thank you. And you're calling from which facility?
[CUSTOMER][NEUTRAL] This will be Baptist Surgery and endoscopy center.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, so I have here 1070973.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, so I have here [PII] with the date of birth of [PII].
[AGENT][POSITIVE] OK, perfect. Thank you. All right, and so you need outpatient benefits, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical and we have an outpatient maximum of $500 per occurrence.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Per occurrence, OK, and is there any sort of um like plan your calendar year, um, max to that um benefit?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] No, it's just a um per occurrence. So meaning if it's related to the same treatment or condition, it needs to be separated by 90 days.
[CUSTOMER][NEUTRAL] OK, separated by 90 days.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Alrighty then, so, so should be wrapping up now then may I just have a reference number for this call?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Excellent then, so that will be all for now. I do appreciate your time taking this call and I hope you have a great day and a great weekend.
[AGENT][POSITIVE] You're welcome. You as well, Mr. [PII], and thank you for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Alright thanks bye bye now