AccountId: 011433970860
ContactId: af0cecc2-8bfe-49a1-96df-bc73d2d9e516
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183539 ms
Total Talk Time (AGENT): 60950 ms
Total Talk Time (CUSTOMER): 81950 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/af0cecc2-8bfe-49a1-96df-bc73d2d9e516_20250113T21:20_UTC.wav
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[AGENT][POSITIVE] Good Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so, this is [PII] and I'm calling from the Fort Lauderdale Eye Institute. Um, I just wanna check benefits for, um, outpatient ambulatory for a patient please. The first name.
[AGENT][POSITIVE] OK, sure, I can.
[CUSTOMER][NEUTRAL] OK, the first name is [PII] and last name is [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] OK, I need a callback number just in case we get disconnected.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh yeah, um, hold on one second here.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And I need the patient's policy number.
[CUSTOMER][NEUTRAL] The policy number is.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] It doesn't show me a policy number is this.
[AGENT][NEUTRAL] Do you see a policy cert? Outpatient cert?
[CUSTOMER][NEUTRAL] Yes, I see that it's OK 1480502, the letter M as in Mary, L as in Louisiana and the number 8.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and you says or OK. All right, thank you, and you say you need outpatient benefits.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK. Before I give you any benefit information, 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 this is one of our secondary supplemental plan to the major medical and we have an outpatient maximum of $500 per day.
[CUSTOMER][NEUTRAL] OK, outstation.
[CUSTOMER][NEUTRAL] Maximum.
[CUSTOMER][NEUTRAL] Oh, a month $500 per day, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] You don't need a CPT code or anything for for that patient? OK.
[AGENT][NEUTRAL] No, no, we are just the secondary supplemental plan to the major medical, so we follow primary.
[CUSTOMER][POSITIVE] OK, alright, no problem, that's all that I needed for today.
[AGENT][POSITIVE] OK. Well, thank you for calling APL. Have a good day, Ms. [PII].
[CUSTOMER][POSITIVE] You're welcome you too bye bye.