AccountId: 011433970860
ContactId: 671341b9-f2e1-40ed-9512-b381020ff7c7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229389 ms
Total Talk Time (AGENT): 104958 ms
Total Talk Time (CUSTOMER): 69671 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/671341b9-f2e1-40ed-9512-b381020ff7c7_20250203T20:37_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. First initial of my last name is [PII], and the first initial of your last name?
[AGENT][NEUTRAL] It is A
[CUSTOMER][NEUTRAL] Thank you. I'm calling from a physician's office. I'd like to check the patient's benefits to make sure that they're active and then to check a CPT code for a CAT scan to see if prior off is needed.
[AGENT][NEUTRAL] OK, I can help you with the benefits and eligibility. Um, Ms. [PII], can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you ma'am and then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] LVPG Lehigh Valley Physicians Group.
[AGENT][POSITIVE] OK. Thank you so much. I appreciate you giving me that information. What is the patient's name?
[CUSTOMER][NEUTRAL] The patient is um doing two patients at the same time. [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. And then what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] It is 623-524-94000.
[AGENT][NEUTRAL] OK. That is a long policy number for us. Um, did she get supply you with another number?
[CUSTOMER][NEUTRAL] Uh, let me just look real quick.
[CUSTOMER][NEUTRAL] OK, this is APL 02573500.
[AGENT][POSITIVE] Yes ma'am that sounds like a good number let me pull that one in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, I do find her.
[AGENT][NEUTRAL] Excuse me, I do show that [PII] does have an active policy. Her effective date is [PII], and this is a supplemental insurance policy. It is billed secondary to the primary. It helps with deductible, co-pay, and co-insurance only, and she has, uh, and this is, you know, just to verify her benefits, it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She has an inpatient benefit calendar year amount of $12,150.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And then she also let me see if she has outpatient services.
[AGENT][NEUTRAL] Yes, she does have an outpatient benefit maximum per covered person of.
[AGENT][NEUTRAL] $2,025.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And no off is ever needed for this supplemental correct?
[AGENT][POSITIVE] Correct, because we're not the primary. You're, you're right.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, alright, sounds good and then a reference number to our phone call?
[AGENT][NEUTRAL] Yes ma'am, you can use my name it's [PII] and today's date.
[CUSTOMER][NEUTRAL] OK, and the time are you Eastern Standard or Central?
[AGENT][NEUTRAL] We are central
[CUSTOMER][NEUTRAL] OK, so you're 241.
[CUSTOMER][POSITIVE] Standard time. OK, sounds good thank you so much, [PII]. I appreciate that.
[AGENT][POSITIVE] You're very welcome, Miss [PII]. I hope you have a good week and thanks for calling APL.
[CUSTOMER][POSITIVE] Oh you too thanks bye bye.
[AGENT][NEUTRAL] Hm.