AccountId: 011433970860
ContactId: a9f14e10-cf6b-4194-bc38-1a9c02eb88e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204020 ms
Total Talk Time (AGENT): 93275 ms
Total Talk Time (CUSTOMER): 69457 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/a9f14e10-cf6b-4194-bc38-1a9c02eb88e4_20250123T16:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling on behalf of Doctor [PII] on a recorded line for quality. I am calling to verify benefits and eligibility for an outpatient surgery.
[AGENT][POSITIVE] It would be my pleasure to assist you, [PII], and.
[AGENT][NEUTRAL] What is the policy number for the patient?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02137700.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Our, our lead already, uh, [PII]. [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Bear with me just one second, let me verify that eligibility for you.
[AGENT][NEUTRAL] I am showing that her policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] This is a secondary policy to her major Medical.
[AGENT][NEUTRAL] And for outpatient coverage.
[AGENT][NEUTRAL] She does have outpatient coverage up to $500 per calendar day.
[AGENT][NEUTRAL] And that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And you guys are secondary. I don't even have our primary. OK, we'll call her, um, so you guys only pay up to $500 so it's an office surgery, so you guys pay a secondary up to $500.
[AGENT][NEUTRAL] Oh, it is in the
[AGENT][NEUTRAL] It is in the doctor's office.
[CUSTOMER][NEUTRAL] Yeah, office surgery.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that would be included under that $500 per calendar day benefit for outpatient. Now, that is because she does have the office treatment writer which does provide benefits for procedures or treatments in office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK cool and then do you guys require any authorization?
[AGENT][NEUTRAL] Authorization is not required and again that is a verification of coverage, not a guarantee of payment. And what is your callback number in case it's needed?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And then lastly, is there any network um that the doctor needs to be in?
[AGENT][NEGATIVE] No network.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty, I believe that is all that I needed. Do you have any call reference number?
[AGENT][NEUTRAL] Call reference number would be my name and today's date, and I spell my name [PII].
[AGENT][NEUTRAL] And anything else I can help you with?
[CUSTOMER][POSITIVE] OK. I I appreciate your help.
[CUSTOMER][POSITIVE] No, that's all. Thank you.
[AGENT][POSITIVE] Thank you for calling APL. You have a wonderful day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.