AccountId: 011433970860
ContactId: 6744c3fe-3aa4-4964-81f3-cce01f1eaf97
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162880 ms
Total Talk Time (AGENT): 54755 ms
Total Talk Time (CUSTOMER): 66704 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/6744c3fe-3aa4-4964-81f3-cce01f1eaf97_20250507T13:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] at Digestive Disease Group.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I was calling to see what type of benefits um this our patient has on this policy.
[AGENT][POSITIVE] OK, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of that patient?
[CUSTOMER][NEUTRAL] Um, they gave us 02597159.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, it looks like this policy is effective [PII]. It's active. And would this be for outpatient services?
[CUSTOMER][NEUTRAL] Um, well, she did have an ambulatory surgical center charge.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh let me pull up her policy.
[CUSTOMER][NEUTRAL] So I guess that would fall under.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] OK, so on this policy, it's not a guarantee of payment basic outline of the plan. Um, they have a $250 calendar day benefit. That's the max it will pay. Um, so how this, it's a secondary policy, so once primary processes.
[AGENT][NEUTRAL] Whatever is left over from primary, it will pay up to 250 per day.
[CUSTOMER][NEUTRAL] OK, and so that's the only type of benefits she has is like outpatient?
[AGENT][NEUTRAL] Yes, there's inpatient as well, which is 2500 per calendar year.
[CUSTOMER][NEUTRAL] OK, we would, yeah, we wouldn't deal with that. Just, we just had offices, it's in pathology.
[CUSTOMER][NEUTRAL] Anastasia.
[CUSTOMER][NEUTRAL] And um facility fee.
[AGENT][NEUTRAL] Yeah, for the facility you would pay.
[CUSTOMER][NEUTRAL] So the only thing that
[CUSTOMER][NEUTRAL] Would be the only thing we would be.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, so this would pay 250 for outpatient services, so for that facility fee.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I just wanted to check. I didn't wanna send the client we, you know, that you wouldn't cover. Alright, thank you.
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye