AccountId: 011433970860
ContactId: b606a4cd-64ed-4f98-bfce-9b8ac2d2f810
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 129710 ms
Total Talk Time (AGENT): 72841 ms
Total Talk Time (CUSTOMER): 36772 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/b606a4cd-64ed-4f98-bfce-9b8ac2d2f810_20250204T20:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], um, at the Oklahoma Proton Center, and I'm needing to check benefits for one of your members and to see if there's any authorization that's required.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, I'll need a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] It is 01792127.
[AGENT][NEUTRAL] OK. And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, for outpatient, we cover up to 5000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim and no authorization is required because this is secondary gap insurance and we go by the primary insurance um guidelines.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And I'm sorry, what were the benefits? 5000 total?
[AGENT][NEUTRAL] Yes, ma'am, her calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's all I need. Is there a reference number for our call?
[AGENT][NEUTRAL] Yes, ma'am. For the reference number, you can use my name and today's date. My name is [PII] um it's spelled [PII] and my last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that's it thank you so much I appreciate it.
[AGENT][POSITIVE] OK, I thank you, [PII], for calling APL. Have a great rest of your day. Bye.
[CUSTOMER][NEUTRAL] Uh huh.