AccountId: 011433970860
ContactId: a6da2433-0ee9-43c2-85dc-195f7844bff5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225800 ms
Total Talk Time (AGENT): 84913 ms
Total Talk Time (CUSTOMER): 63480 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/a6da2433-0ee9-43c2-85dc-195f7844bff5_20250626T13:06_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling to get benefits and eligibility on a patient, please.
[AGENT][NEUTRAL] Sure, I can assist you with that. [PII], could you provide me with the spelling of your name and the callback number?
[CUSTOMER][NEUTRAL] It's [PII] A callback number is [PII].
[AGENT][NEUTRAL] And what is the policy number of the member that you're calling to verify benefits for?
[CUSTOMER][NEUTRAL] It is 02556440 M like Mary L like Larry number 8.
[AGENT][NEUTRAL] Thank you, [PII], can you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And I'm sorry your name was again?
[AGENT][NEUTRAL] You, my name is [PII].
[CUSTOMER][POSITIVE] Thank you [PII].
[AGENT][NEUTRAL] You're welcome, and [PII], you're calling to verify benefits eligibility for what place of service?
[CUSTOMER][NEUTRAL] Uh, the patient's doing an outpatient procedure.
[AGENT][NEUTRAL] Would it be considered as an outpatient surgery center?
[AGENT][NEUTRAL] Or office visit.
[CUSTOMER][NEUTRAL] No outpatient office.
[AGENT][NEUTRAL] Thank you. So this policy has been active since [PII] and it's currently active. The member has outpatient benefits of $8700 per calendar year. This is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] And I'm sorry, how much was that one more time? The outpatient benefit was?
[AGENT][NEUTRAL] $8700 per calendar year.
[CUSTOMER][NEUTRAL] OK, and um do you know how much of that has been used as of yet, [PII]?
[AGENT][POSITIVE] Looks like she's utilized her entire benefit of, well, she's utilized 8500.
[CUSTOMER][NEUTRAL] $8500. OK, so she's got like $200 left then basically.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Actually I do have another patient if you could help me out with please.
[AGENT][NEUTRAL] Sure, give me one moment.
[CUSTOMER][POSITIVE] Not a problem.
[AGENT][NEUTRAL] What is your next policy number?
[CUSTOMER][NEUTRAL] Nex policy number is 1,070,980.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth that you requested benefits for?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][POSITIVE] Outpatient benefits as well.
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] This policy has been active since [PII] and is currently active.
[AGENT][NEUTRAL] This member has outpatient benefits of $500 per occurrence, and when I say occurrence, meaning is in $500 per diagnosis.
[AGENT][NEUTRAL] It's a 90 day period and this is not a guaranteed benefit just a disclaimer of the policy coverage.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Perfect, not a problem. Thank you so much then, [PII], for your help. That would actually be all. Have a wonderful day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. You have a great one as well, [PII]. Goodbye.
[CUSTOMER][NEUTRAL] Goodbye.