AccountId: 011433970860
ContactId: 5adf4178-1c3b-4667-9d3e-516d4c265c6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 289540 ms
Total Talk Time (AGENT): 120774 ms
Total Talk Time (CUSTOMER): 83961 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/5adf4178-1c3b-4667-9d3e-516d4c265c6c_20250320T20:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from a doctor's office. I have a patient here and I just wanna make sure if, if this insurance covers any co-pays or deductibles.
[AGENT][POSITIVE] OK, I can help you with the benefits for the patient. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Ortho, Florida.
[AGENT][NEUTRAL] OK, and can I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Mhm it's [PII] [PII].
[CUSTOMER][NEUTRAL] And the payer ID is 60801.
[AGENT][NEUTRAL] OK, and what is the insured's policy number?
[CUSTOMER][NEUTRAL] Uh, it's 2044 I'm sorry 204-733-61 M as in Mary, L as in Larry 8.
[AGENT][POSITIVE] Thank you. I appreciate that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me look that up real quick.
[AGENT][NEUTRAL] OK, let me repeat that because I might have got something wrong. 204-733-61 ML7, is that correct?
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] ML 82.
[CUSTOMER][NEUTRAL] Instead of a 7, yeah, instead of a 7 it's an 8 because we're in a hospital.
[AGENT][NEUTRAL] OK, 204-733-61 ML 8.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] OK, that policy number is not pulling up for me.
[AGENT][NEUTRAL] Can you repeat the first?
[CUSTOMER][NEUTRAL] Because he hasn't out
[AGENT][NEUTRAL] Can you repeat
[CUSTOMER][NEUTRAL] Because he has an out benefit number and a hospital number. I'm giving you the outpatient benefit number.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, can you give me the the actual numbers again, please?
[CUSTOMER][NEUTRAL] Yeah, 2024.
[CUSTOMER][NEUTRAL] 73361.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, and the number 8.
[AGENT][NEUTRAL] OK, I've got it pulled up now. OK, I do show that [PII] does have an active policy and his effective date is for [PII].
[AGENT][NEUTRAL] And this is just to verify his benefits. It's not a guarantee of payment. This is, um, you are correct, a supplemental insurance policy that's billed secondary to the primary. It does help with deductible, co-pay and co-insurance. Uh, for outpatient, he has $300 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so it does cover any office co-pays.
[AGENT][NEUTRAL] Let me check to make sure he has office visits.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me just a second while I pull up his policy. I'm gonna have to read it and review it. It's gonna be just a moment.
[CUSTOMER][POSITIVE] Mhm, no problem.
[AGENT][MIXED] OK, it does not include offices.
[CUSTOMER][NEUTRAL] It does.
[AGENT][NEGATIVE] Does not.
[CUSTOMER][NEGATIVE] Oh, it does not. OK.
[CUSTOMER][NEUTRAL] OK perfect can I have your name and a reference number?
[AGENT][NEUTRAL] Yes ma'am, my name is [PII] and you can use my name and today's date.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] You're very welcome, Miss. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] So they could just hold on.
[CUSTOMER][NEUTRAL] No, that was all.
[AGENT][POSITIVE] OK, thank you. You have a good day and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you, you're welcome.