AccountId: 011433970860
ContactId: b4ae9b4a-faec-4e19-acb9-05b8c64483eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235389 ms
Total Talk Time (AGENT): 96483 ms
Total Talk Time (CUSTOMER): 73555 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/b4ae9b4a-faec-4e19-acb9-05b8c64483eb_20250227T20:36_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, what's the first initial of your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you. I'm calling for benefits on a patient.
[AGENT][NEUTRAL] OK, and what's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], what's the policy number?
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] 02474464
[AGENT][POSITIVE] Thank you. And what's a good call back?
[CUSTOMER][NEUTRAL] The letter M oh sorry.
[AGENT][NEUTRAL] Yeah, I just the number before the ill is fine, thank you. Uh, what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Give me one.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, give me one second to pull up the file, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEUTRAL] And [PII], you said that you're checking claim status. Can you give me the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Um, yes, patient data of service, well, no, it's not for claims, it's for benefits.
[AGENT][NEUTRAL] Oh, for benefits. Oh, thought I hurt claims and is it for in office?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, they're coming in on.
[CUSTOMER][NEUTRAL] It's outpatient for a CT a PET scan, sorry.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] So I'm showing the policy effective date is [PII]. The policy is active and I'll be providing the maximum outpatient benefit which is up to $500,000.
[AGENT][NEUTRAL] Per calendar year.
[CUSTOMER][NEUTRAL] Or kind of OK.
[AGENT][NEUTRAL] And of course the information provided is verification, not a guarantee of payment, and I do not show that any of that benefit has been used for um this patient at this time.
[CUSTOMER][NEUTRAL] OK perfect and do you guys give reference numbers?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference T as in [PII].
[AGENT][NEUTRAL] ONYA and first initial last name is [PII] and any other questions I could help with today?
[CUSTOMER][POSITIVE] That's it thank you um actually you know what, do you have a group name and number?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Do you have a copy of her card?
[CUSTOMER][NEUTRAL] I don't not here no.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] This information is also on the medical ID card. I'm showing the group number is 26,330. Legacy Healing is the name of the group.
[CUSTOMER][NEUTRAL] Legacy, and then what was, how do you spell the second word?
[AGENT][POSITIVE] Hell, like you heal, healing.
[CUSTOMER][POSITIVE] Oh, healing. OK, got it. OK, perfect. And then the policy number I put it in my system without the ML8.
[AGENT][NEUTRAL] So are you asking a question or just making a statement?
[CUSTOMER][NEUTRAL] What of it?
[CUSTOMER][NEUTRAL] No, I'm asking the ID number in my system. Do I put it in without the, the letter ML and the number 8 at the end?
[AGENT][NEUTRAL] Yeah, it's, it's up to you when the claim is submitted it doesn't require that, just the numbers before the M.
[CUSTOMER][POSITIVE] Got it. OK, thank you so much have a great day.
[AGENT][POSITIVE] Alrighty, thank you for calling APL [PII]. Have a good day as well.
[CUSTOMER][NEUTRAL] You too bye bye.