AccountId: 011433970860
ContactId: 965275cb-6e6a-4990-8970-04a5349ff16c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 133059 ms
Total Talk Time (AGENT): 64680 ms
Total Talk Time (CUSTOMER): 57668 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/965275cb-6e6a-4990-8970-04a5349ff16c_20250127T20:07_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm calling from the Han Institute. I need to get benefits, um, for this patient for inpatient outpatient benefits and if office visits are covered.
[AGENT][POSITIVE] I'd be happy to assist with benefits. May I have your first name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], if I can get a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] I have 1448501 M as Melissa, L as in Larry, and 8 at the end, the number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII], and I do show for inpatient, the calendar year maximum is $1000 and for outpatient, the calendar, excuse me, the per day maximum is $500. Of visits are covered. They're covered under the outpatient.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] However, only treatment and procedures are covered. The copay associated with the physician's charges is not.
[CUSTOMER][NEUTRAL] OK, so you said it was $1000 per calendar?
[AGENT][NEUTRAL] For inpatient.
[CUSTOMER][NEUTRAL] OK, and for out you said it was 500?
[AGENT][NEUTRAL] Per day.
[CUSTOMER][NEUTRAL] OK, and has she met anything and all that?
[AGENT][NEGATIVE] It's not met, it's, that's her benefit, but she hasn't used anything, no.
[CUSTOMER][POSITIVE] Got it. OK, and that coverage and they used, OK.
[CUSTOMER][NEUTRAL] And you said office visits are not covered like the copays correct?
[AGENT][NEUTRAL] Office, the co-pay, any treatment and procedures at the visit would be covered, but not the copay associated with the physician's charges.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Not, yes, that's what I needed. OK, perfect, [PII], and do you have a reference number for this call or just your, the initials to your last name?
[AGENT][NEUTRAL] It's just my name and today's date and time. Was there anything else I could assist with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that'll be all thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.