AccountId: 011433970860
ContactId: aa143fe5-f512-41ed-8d94-f130ad81e570
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230509 ms
Total Talk Time (AGENT): 105082 ms
Total Talk Time (CUSTOMER): 52992 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/aa143fe5-f512-41ed-8d94-f130ad81e570_20250207T20:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII]. I'm calling to verify a patient's benefits.
[AGENT][NEUTRAL] OK. Is this for service in a doctor's office, [PII]?
[CUSTOMER][NEUTRAL] Uh, a facility.
[AGENT][NEUTRAL] OK. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do. um 02552102.
[AGENT][NEUTRAL] OK, what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] Alright thank you [PII] so we're checking eligibility and then outpatient facility benefits, is that right?
[CUSTOMER][POSITIVE] Yes, yes, please.
[AGENT][NEUTRAL] Alright, so I show the policy effective date is [PII]. This policy is active at this time.
[AGENT][NEUTRAL] And the maximum outpatient benefit.
[AGENT][NEUTRAL] It's up to 7000.
[AGENT][NEUTRAL] $350?
[AGENT][NEUTRAL] That's per covered per covered person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And give me one moment.
[AGENT][NEUTRAL] I believe.
[AGENT][NEUTRAL] Alright, so the maximum outpatient benefit is up to $7300 7350 dollars per covered person per calendar year, and then there's a maximum of up to $22,050 per calendar year for all covered persons combined.
[AGENT][NEUTRAL] And of course the information.
[CUSTOMER][NEUTRAL] You said
[AGENT][NEUTRAL] It's individual
[CUSTOMER][NEUTRAL] You said I'm sorry, 1200 individual is 70 OK, OK, OK, got it.
[AGENT][NEUTRAL] It's a, it's individual, yeah.
[AGENT][NEUTRAL] Yeah, I was giving you the family maximum of $22,050 but it's just one person under this policy, so that wouldn't apply.
[CUSTOMER][NEUTRAL] Oh, OK, got it. OK, is there, is there any accumulation?
[AGENT][NEUTRAL] Right. And of
[AGENT][NEUTRAL] I'm checking that for you and any information any information provided is verification, not a guarantee of payment um at this time I do not show any claims on file for year [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, no, you're good. Sounds good. All right, so, and I'm sorry I didn't catch your name.
[AGENT][NEUTRAL] You'll use my name in today's date is your reference. It's [PII] First initial last name is [PII] and any other questions I can assist with today, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That was it. Thank you so much. I appreciate your help.
[AGENT][POSITIVE] So you're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye bye.