AccountId: 011433970860
ContactId: 83f6471c-2f50-40c4-b536-19678e7ad6e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 134270 ms
Total Talk Time (AGENT): 59935 ms
Total Talk Time (CUSTOMER): 48007 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/83f6471c-2f50-40c4-b536-19678e7ad6e4_20250312T14:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], my name is [PII] with Missouri Institute. I just need to see if I can get benefits on a patient and make sure that we're in network.
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Um, I have 023-273-86.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, I have [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm showing the policy effective date is [PII]. Policy is active at this time. Is this a dental office or medical?
[CUSTOMER][NEUTRAL] Um, is, um, no, we're medical.
[AGENT][NEUTRAL] OK, so that's a dental policy number that I have.
[AGENT][NEUTRAL] That you gave me, so let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's mark that out.
[AGENT][NEUTRAL] The medical policy number is 232.
[AGENT][NEUTRAL] 7385.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Last digit is 5.
[CUSTOMER][NEUTRAL] OK, that'll work.
[AGENT][NEUTRAL] And you said that this is service at an office setting?
[CUSTOMER][NEUTRAL] Um, well, she will come in for a specialty office visit and, but we have our schedule we have her scheduled for a cataracty valve, so if she is qualifies for cataract surgery, then, um, we, it would be in an ambulatory surgery.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So outpatient?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so there is an office visit benefit under the policy which covers up to $75 per visit. Uh, the number, the maximum number of visits per calendar year are $5 an outpatient facility is not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is what I will let her know.
[AGENT][NEUTRAL] OK, and of course any information provided is verification, not a guarantee of payment, and did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Domain.
[AGENT][POSITIVE] All right, well thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.