AccountId: 011433970860
ContactId: 89cbc25f-c00d-490f-9834-288ab5b1fb52
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182199 ms
Total Talk Time (AGENT): 114082 ms
Total Talk Time (CUSTOMER): 83035 ms
Interruptions: 3
Overall Sentiment: AGENT=2.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/89cbc25f-c00d-490f-9834-288ab5b1fb52_20250407T13:34_UTC.wav
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[AGENT][NEUTRAL] Good Morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] Hi, hello. Good morning. My name is [PII]. I'm the surgical coordinator for, uh, provider. I'm calling in regards to benefits and coverage for mutual patient.
[AGENT][POSITIVE] OK, be glad to help you and go ahead, [PII] and give me a good policy number.
[CUSTOMER][NEUTRAL] OK, policy number is 02493395 letter M for Mary L for Larry 8.
[AGENT][POSITIVE] Alrighty [PII], thank you so much for all that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Alrighty, thank you so much for all the information, [PII]. Now your patient's name and date of birth today for me, please, ma'am.
[CUSTOMER][NEUTRAL] Last name?
[CUSTOMER][NEUTRAL] Of course, [PII] [PII].
[AGENT][NEUTRAL] Alrighty [PII], thank you so much for all of that information. It looks like Alma is the insured on this medical supplemental plan. I do show the original effective date is [PII]. Patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, and you did say you want benefits. Is that correct?
[CUSTOMER][NEUTRAL] And how do you feel frequency, burning.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, what type of benefits are you needing today?
[CUSTOMER][NEUTRAL] OK. Um, we're, she's undergoing a surgical procedure, so I want to just verify the outpatient facility coverage. OK, perfect, give me one sec.
[AGENT][NEUTRAL] Outpatient facility. All right, let me get that benefit pack pulled up and of course what we are now is just her medical supplemental plan. So the only thing that we would pick up and pay for is anything that is applied towards patients deductible, co-pay, or co-insurance, and her primary insurance carrier, and we only pay for sickness and injury. No routine here is covered no matter what.
[AGENT][NEUTRAL] Now her outpatient benefit here is a zero deductible, no pre-cert, and she has a $500 per calendar year benefit.
[CUSTOMER][NEUTRAL] Lo
[CUSTOMER][MIXED] OK, 0 deductible for all patients.
[AGENT][NEUTRAL] Mhm, let's see if she's used any, looks like as of today she's not used any of that $500 2025 dollars benefit at all, [PII].
[CUSTOMER][POSITIVE] OK perfect sounds great.
[AGENT][NEUTRAL] OK. All right. Is that all I can help you with?
[CUSTOMER][NEUTRAL] OK, can you help me with a reference number please?
[AGENT][NEUTRAL] Yes, ma'am, we do not give a reference number, [PII], but you can use my name with today's date if you need to do so. And is that all that I can help answer for you today?
[CUSTOMER][NEUTRAL] OK, so you are.
[CUSTOMER][NEUTRAL] I decided to.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Could you repeat to me your first name please?
[AGENT][NEUTRAL] I sure will. It's [PII] spelled [PII]
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK. Perfect, thank you so much for your help you have a wonderful day.
[AGENT][POSITIVE] Yes, ma'am, [PII], you as well and thanks for calling APU. Bye-bye.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Bye bye.