AccountId: 011433970860
ContactId: 62f6da9a-2dde-4d74-a6b8-905841cabd01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246300 ms
Total Talk Time (AGENT): 113900 ms
Total Talk Time (CUSTOMER): 81307 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/62f6da9a-2dde-4d74-a6b8-905841cabd01_20250204T15:27_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi, this is [PII] with Acumen. I need to confirm benefits and eligibility, please.
[AGENT][NEUTRAL] OK, sure, I can assist you with eligibility and benefits, Ms. [PII], and um may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, um.
[CUSTOMER][NEUTRAL] 1416441 M for Mary, L for Larry, 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you said you need eligibility and benefits. What type of service is being run for benefits right?
[CUSTOMER][NEUTRAL] It's for a PET scan.
[AGENT][NEUTRAL] Outpatient facility.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, um, office setting.
[AGENT][NEUTRAL] Office, OK.
[AGENT][NEUTRAL] Bear with me just a second. I think we have a different policy for this number. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we do. Um, let me know when you're ready for the new policy number.
[CUSTOMER][NEUTRAL] OK, so that's not right. Let me go in hold on.
[CUSTOMER][NEUTRAL] Mm sorry the system takes a minute to open a page.
[AGENT][POSITIVE] it's OK, no worries, I understand, trust me.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK [PII].
[CUSTOMER][NEUTRAL] Alright, what's the new policy?
[AGENT][NEUTRAL] OK, the new policy number is 02554598.
[AGENT][POSITIVE] The effective
[CUSTOMER][NEUTRAL] So 0202554598?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, that is correct. And the effective date is [PII] and it is showing active at the moment.
[CUSTOMER][NEUTRAL] [PII] current.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, and then how it covered?
[AGENT][NEUTRAL] OK, and let's see.
[AGENT][NEUTRAL] OK, so, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an outpatient maximum of $500 per day. This includes office treatments or procedures.
[CUSTOMER][NEUTRAL] Is it one time per year or is it unlimited?
[AGENT][POSITIVE] It's, it's $500 per day. So it's a daily benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 1 pays a max of 500 per day. Perfect. No, I needed, correct?
[AGENT][NEUTRAL] No, we have a primary.
[CUSTOMER][NEUTRAL] Alright and then um how do you spell your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Alright, perfect. Do you have a call reference number for me?
[AGENT][NEUTRAL] We don't, you can use my name in today's date.
[CUSTOMER][POSITIVE] So in 24235 perfect. Alrighty well thank you so much. And after the 500 is patient responsibility, correct?
[AGENT][NEUTRAL] If it's more than 500 a day, um, more than likely it's gonna be patient's responsibility. We're not the, the primary. So, um, whatever is remaining is up to the provider's discretion, but you can go back to that primary insurance, EOB.
[CUSTOMER][NEUTRAL] OK, and then you guys don't, don't use a network, right? And another network it's gonna be covered at 500, right?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] No. Mm.
[AGENT][POSITIVE] Correct, yes. Mhm.
[CUSTOMER][POSITIVE] OK, so thank you so much for your time.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye bye