AccountId: 011433970860
ContactId: 85c2ef4b-6d36-46e4-b3b5-5d9941c33445
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225160 ms
Total Talk Time (AGENT): 78817 ms
Total Talk Time (CUSTOMER): 85570 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/85c2ef4b-6d36-46e4-b3b5-5d9941c33445_20241231T15:25_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] Yes, hi, I'm calling from Mount Sinai, um, in regards to a patient that is having an X-ray. Um, I just wanted to make sure, um, what are the benefits, uh, for, for a patient for to have an X-ray.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] OK, sure, I can assist you with benefits and may I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected to Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, it would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yes
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I just had it.
[CUSTOMER][NEUTRAL] OK, so the clean the.
[CUSTOMER][NEUTRAL] Medical ID, I don't know if it's outpatient benefit certification number. Yeah, it should be that 1 [PII] [PII].
[AGENT][NEUTRAL] Yeah. Mhm.
[AGENT][NEUTRAL] OK, what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It would be [PII] or [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Perfect. Thank you. And this is gonna be, I'm sorry, outpatient facility or office?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] Outpatient hospital.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and we have um let's see, outpatient maximum is.
[AGENT][NEUTRAL] 250 per day.
[CUSTOMER][NEUTRAL] So only 250 per day.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So for example if a patient has um.
[CUSTOMER][NEUTRAL] Uh, deductibles still do. They can only pay like you guys pay only 250. The rest has to be covered by the patient, correct?
[AGENT][NEUTRAL] Correct. Um, yes, uh, just an example, if um if they have a deductible and the amount that is applied towards the deductible is $500 then we'll cover the $250 and the members responsible for the other 250.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what was your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK per.
[CUSTOMER][NEUTRAL] Um, OK, and, and that would be it, right? Just 250?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, mhm. Yes, to 50 per day. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right then thank you that would be it then.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good day, Ms. [PII].
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.