AccountId: 011433970860
ContactId: ae2f20e6-d805-4179-8db5-a9dd413ce46c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203740 ms
Total Talk Time (AGENT): 123420 ms
Total Talk Time (CUSTOMER): 64021 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/ae2f20e6-d805-4179-8db5-a9dd413ce46c_20250109T19:44_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon. I'm calling for benefits, please.
[AGENT][POSITIVE] It would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII], and what is a good callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] I have 02482778. M as in mom, L Larry, number 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth please, ma'am.
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] All right, thank you. And I understand you're needing eligibility and benefits for [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Benefits, yes, mhm.
[AGENT][NEUTRAL] Alright, I can help you with that. [PII], I am showing that her policy is active as of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a secondary policy to her major medical policy.
[AGENT][NEUTRAL] And what type of benefits are you needing, please?
[CUSTOMER][NEUTRAL] It's gonna be for outpatient and inpatient benefits.
[AGENT][POSITIVE] OK, and I can help you with those benefits for outpatients, she does have a benefit of $200 per calendar day.
[AGENT][NEUTRAL] And that's a per day benefit for inpatient hospital, she has a $7000 benefit that is a per calendar year benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is a verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, and can I get your name and a reference number, please? Oh, I forgot to ask you. I'm sorry, ma'am. Um, does the plan covers co-payments in office copayments?
[AGENT][NEUTRAL] My name is
[AGENT][POSITIVE] Sure, not a problem.
[AGENT][NEUTRAL] For the visit, it does not cover the office visit co-pay.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] It does cover any procedures or treatments in office, but not for the office visit.
[CUSTOMER][NEUTRAL] No, she's having um an ultrasound and it's under the copayment with her with her primary plan.
[AGENT][NEUTRAL] So the ultrasound could be considered for payment, but for the visit, it was not. So the visit is the only thing that's not covered, like the 99213 or but the um diagnostic testing is covered in the doctor's office.
[CUSTOMER][NEUTRAL] The ultrasound cookie.
[CUSTOMER][NEUTRAL] Got it. OK.
[AGENT][NEUTRAL] Now, I can't guarantee payment, but I can guarantee the benefit.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, ma'am thank you just the reference number and your name.
[AGENT][NEUTRAL] Hey.
[AGENT][NEUTRAL] The reference, sure, the reference number is my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] And it was a pleasure to assist you with those benefits for [PII], thank you for calling APL and I hope you have a wonderful afternoon.
[CUSTOMER][POSITIVE] You too, ma'am. Thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye bye.