AccountId: 011433970860
ContactId: 63a37a68-d978-45e7-93d1-1a86fb33352b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 143669 ms
Total Talk Time (AGENT): 67739 ms
Total Talk Time (CUSTOMER): 64381 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/63a37a68-d978-45e7-93d1-1a86fb33352b_20250417T19:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm just trying to find out um I have a patient, she has APL, but I believe it's only covered for outpatient hospital. Can you verify that for me?
[AGENT][NEUTRAL] Of course. May I have your name?
[CUSTOMER][NEUTRAL] Sure, my name is [PII] initial [PII]
[AGENT][NEUTRAL] Thank you, [PII] and your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you very much and may I have the policy number please?
[CUSTOMER][NEUTRAL] Uh, policy number is, oh, I just saw it, OK, um, the outpatient one, which I believe is hospital is 1,306,730 M as in Mike L as in Larry 8.
[AGENT][POSITIVE] Thank you so much, [PII], one moment please.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] Thank you. And verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, date of birth is [PII].
[AGENT][POSITIVE] Thank you so much and you're calling to verify if she has only outpatient benefits?
[CUSTOMER][NEUTRAL] I believe she's having surgery at a surgical center, but on all the other cards so people that I've called on, they've only had like outpatient hospital benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not really surgical centers.
[AGENT][NEUTRAL] Well that will fall under outpatient so for outpatient benefits, let me give you those benefits for outpatient one moment.
[CUSTOMER][NEUTRAL] But it covers at a surgical center?
[AGENT][NEUTRAL] It does. That's the covered place of service, um, one moment please.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, please note verification of benefits provided does not guarantee payment. We pay up to $5000 for the calendar year and of course we help with her major medical deductible, co-pay and co-insurance based on coverage. And again we pay up to $5000 for the year to help with that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And has she used anything?
[AGENT][POSITIVE] Let me check that for you as well. Give me one moment please, [PII]. Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, currently she has only used $75.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, and can I get a reference number?
[AGENT][NEUTRAL] We do not use reference numbers, but please you can use my name [PII], last name initial [PII], and today's date, please.
[CUSTOMER][NEUTRAL] Here
[CUSTOMER][POSITIVE] Good
[CUSTOMER][POSITIVE] Perfect great thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day, [PII]. Bye.
[CUSTOMER][NEUTRAL] OK bye bye.