AccountId: 011433970860
ContactId: 8fe0c6b2-165a-4e8c-8ceb-2ac5f6bf5d29
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 156369 ms
Total Talk Time (AGENT): 79881 ms
Total Talk Time (CUSTOMER): 63128 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/8fe0c6b2-165a-4e8c-8ceb-2ac5f6bf5d29_20250205T22:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from uh this outpatient. I'm calling in reference to a new outpatient. I'm trying to obtain outpatient benefit under this member's plan.
[AGENT][NEUTRAL] OK, I can help you with benefits, Ms. [PII], and what was the name of the facility you said you were calling from again, please?
[CUSTOMER][NEUTRAL] But this outpatient services.
[AGENT][NEUTRAL] OK, thank you, and then Miss [PII], what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] You're
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII].
[AGENT][NEUTRAL] Thank you ma'am and then what is the patient's name?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes, patient's name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you. And then what is [PII]'s, uh, policy number, please?
[CUSTOMER][NEUTRAL] 02161358 M as in Mike L as in Lima and number 8.
[AGENT][NEUTRAL] OK, thank you, let me pull that policy in for us.
[CUSTOMER][POSITIVE] Yes, take your time.
[AGENT][NEUTRAL] OK, I do see that [PII] does have an active policy with us. Her effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify her coverage. It's not a guarantee of payment. She has a supplemental insurance policy that's billed secondary to the primary. It's a gap plan that helps with deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] She has an inpatient calendar year benefit amount of $1000 and she also has an outpatient calendar year benefit amount of $1000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Does anything has been used for, uh, from the month?
[AGENT][NEUTRAL] Let me look real quick for you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] No, ma'am, there's nothing been used for the year of [PII].
[CUSTOMER][POSITIVE] Beautiful. The last thing I may need is gonna be if you can provide me with the initial of your last name and the reference number if it's possible.
[AGENT][NEUTRAL] Yes, ma'am. My initial is [PII] and you can use my name and today's date for your reference.
[CUSTOMER][POSITIVE] Beautiful. Thank you so much for your help and I truly appreciate everything.
[AGENT][POSITIVE] You're very welcome. You have a good day, Ms. [PII], and thank you for calling APL.
[CUSTOMER][POSITIVE] Same to you. Have a good one. Bye.
[AGENT][NEUTRAL] Mm, bye-bye.