AccountId: 011433970860
ContactId: 7dfb4b7f-b49d-4720-a48b-3a243b8ad4a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242250 ms
Total Talk Time (AGENT): 99673 ms
Total Talk Time (CUSTOMER): 83969 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/7dfb4b7f-b49d-4720-a48b-3a243b8ad4a3_20250121T21:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling
[AGENT][NEUTRAL] APL, my name is [PII]. How may I help you? Sorry.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the facility to check benefits and eligibility.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the eligibility and benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure, my callback number is [PII]. It's a direct line and sorry uh.
[CUSTOMER][NEUTRAL] And the thing what you asked for.
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] OK, the policy number I have is 0244783, sorry, it's 02444783.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII] and the last name spelled as [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing that the policy is active. It's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] I need benefits for hospital ambulatory surgical.
[AGENT][NEUTRAL] OK, so for outpatient, the policy should could pay up to $3000 per person per calendar year.
[AGENT][NEUTRAL] That does include surgery in a hospital outpatient facility or a free-standing outpatient surgery center.
[CUSTOMER][NEUTRAL] OK, and sorry, the effective date is [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And uh there's any coinsurance copay, deductible and out of pocket?
[AGENT][NEUTRAL] Um, no, this is their secondary policy, so we help pay those um charges if they are charged. Did you want to see if she's, if she's used any for the year?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] OK, so I'm showing for the year [PII], there have been no benefits used.
[CUSTOMER][NEUTRAL] OK, so it, is it a Medicare supplement plan?
[AGENT][NEUTRAL] No, this policy is second to their, hold on one moment, United Healthcare policy only.
[CUSTOMER][NEUTRAL] OK, it's a secondary plan and it covered um
[AGENT][NEUTRAL] We pay towards the.
[CUSTOMER][POSITIVE] It covered 100%.
[AGENT][NEUTRAL] We pay towards the copay, deductible and co-insurance of covered charges after primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh so there's no insurance copay deductive out of pocket and there's any group name and group number?
[AGENT][NEUTRAL] So the um group number is 261.
[AGENT][NEUTRAL] 43
[AGENT][NEUTRAL] And the group name is Practice Promotions LLC.
[CUSTOMER][NEUTRAL] Practice promotion.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much and uh can I get your name again once again sorry I missed out.
[AGENT][NEUTRAL] Oh, sure. My name is [PII] The [PII].
[CUSTOMER][NEUTRAL] And can I get the call reference number for this call?
[AGENT][NEUTRAL] Um, so there's no call reference number, um, but you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, OK, thank you, Ms. [PII]. Thanks for your time and assistance and have a wonderful day. Thank you.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] Bye bye.