AccountId: 011433970860
ContactId: 747c221a-d837-4d3b-91ee-f497184fe1e7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167380 ms
Total Talk Time (AGENT): 91692 ms
Total Talk Time (CUSTOMER): 60591 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/747c221a-d837-4d3b-91ee-f497184fe1e7_20250221T15:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, uh, good morning. My name is [PII]. I'm calling from the physician office to verify patients benefits.
[AGENT][POSITIVE] Yeah, I can take benefits for you. I'm sorry, you said your name was [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] And please, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] account
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's 02450100 ML 8.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] OK perfect thank you for verifying that. Uh, so this policy is active effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at the outpatient benefits.
[CUSTOMER][NEUTRAL] Uh, yes, please.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so the outpatient benefit is on a per calendar day basis but it pays $750 max per calendar day.
[CUSTOMER][NEUTRAL] Do you
[CUSTOMER][NEUTRAL] OK, so that's per calendar day and that includes also inpatient services.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, the inpatient benefit is separate, um, and that one is going to be based, uh, it's per confinement and that pays $2000 max per confinement.
[CUSTOMER][NEUTRAL] So $2000 that would be the same per calendar day?
[AGENT][NEUTRAL] It's per confinement, so however long they're um inpatient for one, you know, particular confinement.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, and that will cover also, um, you only copay as well, right? so office visit would be covered.
[AGENT][NEUTRAL] Oh yeah, it's so it's um co-pay deductible and co-insurance after major medical pays.
[CUSTOMER][POSITIVE] Alright, great, thank you so much. um, may I have please your name and and the reference number?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] And was there anything else I could help you with?
[CUSTOMER][POSITIVE] No thank you so much for your help have a nice day.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. You too, bye bye.
[CUSTOMER][POSITIVE] Thank you bye bye.