AccountId: 011433970860
ContactId: 8b7e0ea9-8e1d-4796-bda0-a2a156191bf4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300820 ms
Total Talk Time (AGENT): 131544 ms
Total Talk Time (CUSTOMER): 129146 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/8b7e0ea9-8e1d-4796-bda0-a2a156191bf4_20250521T15:58_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII], last initial [PII] I'm calling to verify the benefits of a patient.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Well [PII], I hope it'd be my pleasure to assist you with benefits. What is the patient's policy? I'm sorry, what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Of course it's gonna be [PII] option one.
[AGENT][NEUTRAL] Thank you, [PII] and the policy number for the patient please ma'am?
[CUSTOMER][NEUTRAL] It is 0167566, M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] 0167566
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, and then 8, the number 8, so ML 8.
[AGENT][NEUTRAL] Are you looking at the card because that is actually lacking a number.
[CUSTOMER][NEUTRAL] Really? let me see. This is the number we were given. Let me see if by any chance we have the picture. No, it's lacking. Can I give you, can we do a name um and date of birth search or no?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Absolutely. What's the last name of the patient?
[CUSTOMER][NEUTRAL] There's 2. There's [PII], that's spelled [PII]. The last name I'm going to spell it out, is or the second part, it's [PII]. So [PII].
[AGENT][NEUTRAL] OK, let's see how this goes. What's the first name?
[CUSTOMER][NEUTRAL] I know it's long. I know, and then the first name is [PII]
[AGENT][NEUTRAL] OK, I didn't come up under that.
[AGENT][NEUTRAL] I might have to try. Do you happen to have the social?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me see
[AGENT][NEUTRAL] Is she in [PII]?
[CUSTOMER][POSITIVE] We do, we actually do.
[CUSTOMER][NEUTRAL] She is in [PII].
[AGENT][NEUTRAL] Let me check this policy and see.
[AGENT][NEUTRAL] And what is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I got her. OK.
[CUSTOMER][NEUTRAL] Perfect thank you. Was it missing numbers or should I, um, is it, are you able to tell me or should I ask the patient?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] No, I got you. I, I can help you. So we actually have her listed as [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] That the [PII] last name is not included.
[AGENT][NEUTRAL] And her
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Her active policy number is 167.
[AGENT][NEUTRAL] 2566.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And the effective date is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] This is a secondary policy to her major medical policy, and what type of benefits are you needing? I can help you with those benefits.
[CUSTOMER][NEUTRAL] Um, for outpatient surgery, she's having outpatient surgery done at our ambulatory surgical center and it's non-hospital based.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] On the the data of service is the [PII].
[AGENT][NEUTRAL] OK, and I can help you with those benefits. She does have outpatient coverage up to $1250. That is a per calendar year benefit.
[AGENT][NEUTRAL] And that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][POSITIVE] Perfect. And has any of that been met?
[AGENT][NEUTRAL] I'm checking on that for you right now because I figured you were gonna ask.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] As of right now, she has used $325.44.
[CUSTOMER][POSITIVE] I'm so sorry, what was that?
[AGENT][NEUTRAL] $325.44.
[CUSTOMER][POSITIVE] And that's how much has been met, so there's still a good amount remaining and.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] It this covers deductible copay, like anything that the primary doesn't cover?
[AGENT][NEUTRAL] Co-pay deductible or co-insurance.
[CUSTOMER][POSITIVE] Perfect. All right, thank you so much. Can I please have a reference number for today's call?
[AGENT][NEUTRAL] Absolutely. The reference number is going to be my name and today's date. I spell my name [PII].
[AGENT][POSITIVE] And [PII], it was a pleasure to help you with those benefits. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that'd be all thank you so much I hope you have a wonderful day.
[AGENT][POSITIVE] I hope you do as well, [PII], and thank you for calling APL. Take care.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.