AccountId: 011433970860
ContactId: 98717825-d9ae-40ca-b4d5-0450b4e369d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168570 ms
Total Talk Time (AGENT): 84650 ms
Total Talk Time (CUSTOMER): 74106 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/98717825-d9ae-40ca-b4d5-0450b4e369d5_20250617T15:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Irmo Outpatient Surgery. Just um trying to see if this member is eligible with insurance.
[AGENT][NEUTRAL] I'm sure [PII] I can assist you. Yes, ma'am. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] You can help me with that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] I'm looking for 02462932 policy number.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII]. Um, her date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's uh outpatient benefits.
[AGENT][NEUTRAL] OK, for services
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is this a secondary insurance? Cause I see she has like a.
[AGENT][NEUTRAL] Yes, ma'am. What we do is cover the copay, the coinsurance, and the deductible after the primary insurance processes the claim. And for outpatient services, we cover up to $4500 per calendar year, but there is a $1500 deductible that needs to be met first.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 1st, $500 deductible and you cover up to $4500 a year for outpatient.
[AGENT][POSITIVE] Right, that's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And she has actually already met her deductible that just popped up.
[CUSTOMER][NEUTRAL] OK, well, um.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, that's great, cool. Oh, I just wanted to see if she, if it was still eligible and if it was secondary so that works, um, that's all I needed.
[CUSTOMER][NEUTRAL] Um, yeah, I'll pay it, make a note.
[AGENT][NEUTRAL] OK. Well, since there isn't anything.
[AGENT][NEUTRAL] Else I can assist you with, [PII]? Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Um, is there a call reference number for today, or?
[AGENT][NEUTRAL] Yeah, so the reference number, you can use my name and today's date. My name is [PII], um it's spelled [PII] Last initial is [PII], and today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, today's date. Alright, thank you, Miss [PII]. You have a good day.
[AGENT][NEUTRAL] OK. You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] All right bye bye.