AccountId: 011433970860
ContactId: 4b022c85-8860-4f11-94a3-4ecc82b759f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315920 ms
Total Talk Time (AGENT): 93537 ms
Total Talk Time (CUSTOMER): 78808 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/4b022c85-8860-4f11-94a3-4ecc82b759f5_20250320T15:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, can you hear me?
[AGENT][NEUTRAL] Yeah, can you hear me?
[CUSTOMER][NEUTRAL] Yes, I can hear you. Sorry, my phone was on mute. Um, my name is [PII]. I'm calling from Baptist Health Surgery Center of Kindle. Um, I was just on the phone with one of your reps. I think her name was [PII].
[AGENT][NEUTRAL] I
[CUSTOMER][NEGATIVE] But the phone got disconnected.
[CUSTOMER][NEUTRAL] And I was going over benefits for a patient. I was wondering if you could help me with that.
[AGENT][POSITIVE] Yeah, absolutely. I can help you with those benefits. Do you have a good callback number just in case our phone gets dropped or call gets dropped?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, and do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's gonna be 0202 again 21.
[CUSTOMER][NEUTRAL] 65 M L 8
[AGENT][NEUTRAL] And do you have the name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, great. Thank you.
[AGENT][NEUTRAL] And this is not a guarantee of payment, just a basic outline of the policy.
[AGENT][NEUTRAL] Um, let's see, and you said benefits, correct? Do you need eligibility as well?
[CUSTOMER][NEUTRAL] Yeah, I'm calling to uh verify benefits for uh outpatient surgery done at a non-hospital based ambulatory surgery center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, outpatient surgery. OK.
[AGENT][NEUTRAL] Um, I do show she is effective for [PII].
[AGENT][NEUTRAL] And she's active.
[AGENT][POSITIVE] Yeah, let's look at those benefits.
[AGENT][NEUTRAL] Just give me a moment. I'm gonna pull up her policy.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Uh, looks like she has let's see.
[AGENT][NEUTRAL] She has an outpatient benefit maximum of 3500 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Do you wanna see if she's used any of that?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, let's look that up.
[AGENT][NEUTRAL] Uh, I don't show she's used anything so far this year.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And would you happen to know if authorization is required for.
[CUSTOMER][NEUTRAL] In order for her to use it today.
[AGENT][NEUTRAL] No, we do not require
[AGENT][NEUTRAL] Prior authorization and just note that this is a secondary policy. So when you do file that claim, be sure and file with the primary explanation of benefits so we can get that processed for you.
[CUSTOMER][NEUTRAL] I'm sorry you broke up. I didn't hear you.
[AGENT][NEUTRAL] Oh, we will need the primary explanation of benefits when you do file that claim.
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] Can I get a name and a reference number for the call?
[AGENT][NEUTRAL] Um, yes, so it is, it's just my name and last initial it's [PII].
[AGENT][NEUTRAL] [PII] and today's date.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Then, um, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Oh, you said, OK, so it's [PII] and today's date [PII]?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's the reference, yep.
[CUSTOMER][NEUTRAL] I'm sorry you keep cutting out when it's time for the reference. I didn't hear you.
[AGENT][NEUTRAL] Yes, that's, it's my name and, and the date.
[CUSTOMER][POSITIVE] OK perfect thank you so much [PII].
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Have a good one you too.
[AGENT][NEUTRAL] You too, bye.