AccountId: 011433970860
ContactId: 6dfb4d82-65ba-4f93-8558-635b9d2a8a00
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219160 ms
Total Talk Time (AGENT): 95041 ms
Total Talk Time (CUSTOMER): 56821 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/6dfb4d82-65ba-4f93-8558-635b9d2a8a00_20250109T14:59_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] My name is [PII]. I'm calling from a provider's office and I'm sorry I did not catch your name.
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. And how may I assist you today, Miss [PII]?
[CUSTOMER][NEUTRAL] I am needing to check benefits and eligibility. I have a CPT and diagnosis code.
[AGENT][POSITIVE] OK, sure, I can assist you with eligibility and benefits. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 01457121.
[AGENT][NEUTRAL] Thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Perfect, thank you. And what type of services being render for benefits?
[CUSTOMER][NEUTRAL] It is an outpatient medical procedure.
[CUSTOMER][NEUTRAL] Do you want the CPT code?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] It is 669-84.
[CUSTOMER][NEUTRAL] That's the only one.
[AGENT][NEUTRAL] OK, bear with me, let me look into that code and see what is it for.
[AGENT][NEUTRAL] And you said it was gonna be an outpatient facility, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK. And all right, and we cannot guarantee payments over the phone until we receive the claim and that's just a disclaimer. And we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medicals. And let's see, we have an outpatient maximum of 2500 per per person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you need any other information?
[CUSTOMER][NEUTRAL] Is there deductible coinsurance?
[AGENT][NEUTRAL] Oh, we're not the major medical.
[AGENT][NEUTRAL] We are the secondary policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And and I understand that, but sometimes secondary does require deductible co-insurance, so that's why I was asking.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] OK, no problem. Yes, this one doesn't.
[CUSTOMER][NEUTRAL] OK and uh can I get a reference number for the call?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] We don't have reference numbers, but you can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh, no, that will do it.
[AGENT][POSITIVE] Yeah, OK, thank you for calling APL. You have a good day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] You're welcome. Bye bye.