AccountId: 011433970860
ContactId: 4ec6a15f-3913-4353-ae02-39f599aeaf90
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193169 ms
Total Talk Time (AGENT): 88596 ms
Total Talk Time (CUSTOMER): 70291 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/4ec6a15f-3913-4353-ae02-39f599aeaf90_20250114T18:17_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. This is So. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm currently calling from a medical office for a patient that we have in common.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He currently uses your insurance as a backup to see if you guys could, um, for the benefits.
[AGENT][POSITIVE] So any benefits today. I'm sure I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] How do you spell that? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And may I have a callback number just in case we get disconnected, Mr.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, um, give me one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have in hospital benefits and outpatient benefit certification number.
[AGENT][NEUTRAL] You can give me either or.
[CUSTOMER][NEUTRAL] OK, um, so it's 02.
[CUSTOMER][NEUTRAL] 2502 34 ML 8.
[AGENT][NEUTRAL] OK, what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What's his date of birth?
[CUSTOMER][NEUTRAL] Um, date of birth is [PII].
[AGENT][NEUTRAL] Thank you, Miss. [PII]. And you say you need benefits and this is gonna be for outpatient facility or office?
[CUSTOMER][NEUTRAL] Um, office outpatient, he's gonna have a minor surgery.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] In the office.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, in office.
[AGENT][NEUTRAL] All right. And 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. And um we do cover office treatments for procedure. This is subject to the outpatient maximum which is $500 per day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, hold on, so he has to pay a total of 295. How much would you guys cover? I'm sorry.
[AGENT][NEUTRAL] When you say 295, is it 2900 or is it?
[CUSTOMER][NEUTRAL] 2, no, no, no, $295.
[AGENT][NEUTRAL] 290.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] If it's 295, that is um more than um that's less than 5, so we'll pay up to 5. So that means it's gonna be paid all of them. Mhm.
[CUSTOMER][NEUTRAL] OK, you'll pay up to 5.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, um, can I get the, if there's um, a reference number to this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Miss?
[CUSTOMER][NEUTRAL] Yes, let me get your name please.
[AGENT][NEUTRAL] Hey, my name is [PII]. That's [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] OK, perfect, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, Miss.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Hm