AccountId: 011433970860
ContactId: 60c5a5b6-9f5e-4292-87c3-2442c5034e5d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 136740 ms
Total Talk Time (AGENT): 80682 ms
Total Talk Time (CUSTOMER): 58094 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/60c5a5b6-9f5e-4292-87c3-2442c5034e5d_20250207T13:36_UTC.wav
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[AGENT][NEUTRAL] Contacting HPO. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hi, yes, good morning. I'm calling because I need to get benefits on a patient for their gap plan.
[AGENT][NEUTRAL] I can help with benefits, whom am I speaking, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. What is that policy number we're looking at today?
[CUSTOMER][NEUTRAL] OK, it's 02337085 ML 7.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. It looks like the policy went into effect on [PII]. It is active. Now that policy um has both in and out of hospital benefits. Is there anything in particular that I can tell you about the policy?
[CUSTOMER][NEUTRAL] Well, one, the ID number that I gave you with the 7, is that for inpatient or outpatient?
[AGENT][NEUTRAL] It's for either it's um it's that's really just an internal uh distinction that we make it when you give that information to us if you turn it in on a claim, it doesn't matter whether you put ML7 or ML 8 we'll know if it gets us to the same place.
[CUSTOMER][POSITIVE] Have a good day
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, cause I usually put 8 for outpatient. That's why I said a little turn off she didn't have her card with her. Um, I need benefits for outpatient. She's gonna have outpatient surgery with us.
[AGENT][NEUTRAL] Yes, we will pick up the deductible, co-payment or co-insurance. It's $1000 per calendar year. That's just the verification of the benefits, not a guarantee of payment. She hasn't used any of it as of this year at [PII], so it's all available.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so she still has it available, OK.
[AGENT][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] Now, and you know where to send the claim? Is there anything else at all that I can help with?
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Um, oh, I have another question. Does it cover office visit co-pays?
[AGENT][NEUTRAL] Uh, no, ma'am, it does not. It just covers the uh outpatient and inpatient.
[CUSTOMER][NEUTRAL] Yes, that's it, yeah.
[CUSTOMER][NEUTRAL] OK perfect um is there a reference number for the call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date as a reference.
[CUSTOMER][NEUTRAL] I'm sorry, what was your first name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Oh, OK, and then [PII], OK.
[AGENT][NEUTRAL] And the first letter yeah uh and we're gonna use that today's date as a reference.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you so much for your help.
[AGENT][POSITIVE] OK, thanks for contacting A you have a good.