AccountId: 011433970860
ContactId: 55e033fa-7ac7-4d7b-87cd-5683388307de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202940 ms
Total Talk Time (AGENT): 94388 ms
Total Talk Time (CUSTOMER): 56174 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/55e033fa-7ac7-4d7b-87cd-5683388307de_20250402T16:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I am trying to get some benefits information on a patient.
[AGENT][POSITIVE] OK, Ms. [PII], I can help you with benefits. Can I please get your phone number in case our call is dropped I'll be able to call you right back.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Uh, Doctor [PII] or the Norman Foot and Ankle clinic.
[CUSTOMER][NEUTRAL] the
[AGENT][NEUTRAL] OK, and can I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It is [PII]. Her date of birth is [PII], and the policy number is 01677928.
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us and her effective date is [PII], and this is just to verify her benefits. It's not a guarantee of payment. She has a supplemental policy that's billed secondary to the primary. It helps with deductible, co-pay and co-insurance.
[AGENT][NEUTRAL] She has an inpatient benefit amount per calendar year of $1000 and then she also has an outpatient benefit amount per calendar year of $1000.
[CUSTOMER][NEUTRAL] So you guys will pay up to $1000 of her deductible from her primary plan.
[AGENT][NEUTRAL] Yes, ma'am, per year.
[CUSTOMER][NEUTRAL] Max, OK, alright. And what about for office visits? is that considered part of the outpatient?
[AGENT][NEUTRAL] Let me look and see if she has office visits, um.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] I'm gonna go ahead and pull her policy up so it's gonna be just a minute while that loads um because I wanna make sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She does not have office visits.
[CUSTOMER][NEUTRAL] OK, so it'll only apply towards outpatient, OK.
[AGENT][NEUTRAL] Right, yes, ma'am.
[CUSTOMER][NEUTRAL] That is what I needed to know. Um, so do I even need to bill you for office visits then, or?
[AGENT][NEUTRAL] Uh, the office visit wouldn't be paid for the physician's part, but she does have, um, a.
[AGENT][NEUTRAL] Uh, treatment benefit.
[CUSTOMER][POSITIVE] OK, alright, we'll just send it over then as soon as the other two are done processing. Alright, thank you for your help.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful day. Is there anything else I can do for you before we go?
[CUSTOMER][NEUTRAL] OK uh.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] That's all for now thank you.
[AGENT][POSITIVE] OK, you take care and thanks for calling APL.
[CUSTOMER][NEUTRAL] OK, uh
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] You're welcome bye.