AccountId: 011433970860
ContactId: a492d6be-98b3-4cef-a295-e6fdcb0ad4df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210979 ms
Total Talk Time (AGENT): 98591 ms
Total Talk Time (CUSTOMER): 56807 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/a492d6be-98b3-4cef-a295-e6fdcb0ad4df_20250418T20:07_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Oh yes, could you spell your name for me?
[AGENT][NEUTRAL] Sure. [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, so I was just calling to get verification of benefits and if any uh prioritization requirements were necessary for a patient.
[AGENT][POSITIVE] OK, sure. I can assist you with benefits and Pria. And may I have your name?
[CUSTOMER][NEUTRAL] Oh yes, [PII] Last name initial is [PII]
[AGENT][NEUTRAL] OK, thank you. And may I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] Thank you. And what's the patient's policy number?
[CUSTOMER][NEUTRAL] Um, that is going to be 02440462.
[AGENT][NEUTRAL] All right, and what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII]
[AGENT][NEUTRAL] Um, perfect. And what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] It's going to be a colonoscopy outpatient hospital surgery.
[AGENT][NEUTRAL] OK, so, and it's a, um, OK, so surgical colonoscopy.
[AGENT][NEUTRAL] Right. Uh, pre-authorization is not gonna be required because this is a secondary supplemental plan to the major medical. Um, before I give you benefits, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And we have an outpatient maximum of 2550 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You said $2550?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK, have they already met that?
[AGENT][NEUTRAL] Let me check and see if they have already used any of that benefit. One moment.
[AGENT][NEUTRAL] OK, so it looks like um Mr. [PII] has not used his benefits as of today for [PII], so he still have the full amount available.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Is there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, could you give me um an effective date?
[AGENT][NEUTRAL] Oh, sure, yes. We have an effective date of, let's see.
[AGENT][NEUTRAL] Um, [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] Uh, hold on just one second, so.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, well, I apologize for that. May I get a reference number?
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Is there anything else I may help you?
[CUSTOMER][POSITIVE] I appreciate your assistance. I hope you have a great weekend.
[AGENT][POSITIVE] You as well, Ms. [PII] and thank you for calling APL.
[CUSTOMER][NEUTRAL] OK bye bye.
[AGENT][NEUTRAL] Bye-bye.