AccountId: 011433970860
ContactId: 6f4e60b7-9f1e-4e7a-82a9-2eb2b8b44bdd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218440 ms
Total Talk Time (AGENT): 69854 ms
Total Talk Time (CUSTOMER): 113987 ms
Interruptions: 0
Overall Sentiment: AGENT=2.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/6f4e60b7-9f1e-4e7a-82a9-2eb2b8b44bdd_20250520T20:55_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Doctor [PII]'s office. I'm just trying to verify benefits on one of our patients.
[AGENT][NEUTRAL] Hi
[AGENT][NEUTRAL] OK, I can assist with it [PII]. What is your callback number please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. What is that policy number, please?
[CUSTOMER][NEUTRAL] The policy where's the policy number?
[CUSTOMER][NEUTRAL] Outpatient benefit center number OK so 02013270 M as in Mary, L as in Larry, the number 8.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I apologize for that, [PII], if you could just repeat that for me one more time.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's 02013270 M as in Mary, L as in Larry, and then the number 8.
[AGENT][NEUTRAL] OK, thank you very much. verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII]
[CUSTOMER][NEUTRAL] And the last name is uh [PII]
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you so much for that verification process, [PII], and you're calling for benefits for outpatient, would this be for an office setting or a facility charge?
[CUSTOMER][POSITIVE] It's gonna be a professional, um.
[CUSTOMER][NEUTRAL] It's gonna be an outpatient surgery, but I'm calling for the professional service. The doctor will be doing the surgery.
[AGENT][NEUTRAL] OK, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Please note verification of benefits provided does not guarantee payment. The outpatient max that we will pay is up to 1500 for the calendar year. Again, that's up to $1500 for the calendar year for covered outpatient services.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Has the patient used up any?
[AGENT][NEUTRAL] Let me check the accumulation for you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Currently, no, the patient has not accumulated anything towards the 1500 for the calendar year.
[CUSTOMER][NEUTRAL] And that's the max they will pay for.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this is after the primary process the claim.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, your name?
[AGENT][NEUTRAL] Uh, yes, of course my name is [PII]. My last initial is [PII], and we did not provide the reference numbers. [PII], you can use my name in today's date. Would you need any information as far as claim submission?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm, um, I mean, let me verify what I have so I have the claim submission of PO Box 248,950, uh, Oklahoma [PII].
[AGENT][POSITIVE] Great, thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That is correct, yes, thank you.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. That's all I needed.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day. Take care. You too, bye.
[CUSTOMER][POSITIVE] Thank you, [PII].
[CUSTOMER][POSITIVE] Have a good one bye bye.