AccountId: 011433970860
ContactId: 643809bc-3e1e-472f-a2d1-cfe32a82dab2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 142250 ms
Total Talk Time (AGENT): 67842 ms
Total Talk Time (CUSTOMER): 46051 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/643809bc-3e1e-472f-a2d1-cfe32a82dab2_20250422T20:26_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, good, good afternoon. Um this is [PII] I'm calling in regarding benefits and eligibility please for one of our patients.
[AGENT][POSITIVE] I'm sure [PII] I can assist you with benefits. Um first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, of course it's [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number.
[CUSTOMER][NEUTRAL] Yes, 02216501.
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lamp. A.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, sorry. [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] It's gonna be for a specialist office visit outpatient surgery.
[AGENT][NEUTRAL] OK, for services provided in office including um outpatient surgery, um we cover up to $200 per day and that's for the co-insurance and the deductible after the primary insurance processes the claim, but any co-pays for office visits is not covered.
[CUSTOMER][NEUTRAL] OK. So for the outpatient surgery, it's $200 per calendar day.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And the office visit is not covered, correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Perfect thank you so much and the reference number please?
[AGENT][NEUTRAL] Um, so the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] Last initial is [PII] like [PII], and today's date. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that would be all. Thank you so much. Have a great rest of your day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.