AccountId: 011433970860
ContactId: b6c0cfb6-d6f3-4d34-bb0b-e3097b86cdb8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195259 ms
Total Talk Time (AGENT): 108624 ms
Total Talk Time (CUSTOMER): 57889 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/b6c0cfb6-d6f3-4d34-bb0b-e3097b86cdb8_20250417T19:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] What's your name again? I'm sorry?
[AGENT][NEUTRAL] Um, it's [PII]. Um it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] I'm, yes, hi [PII]. I'm calling you from the Han Institute. My name is [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I'm calling because I need to get um benefits for a patient. I need to know if the patient is covered office visits and I need inpatient outpatient benefits.
[AGENT][POSITIVE] I'm sure one day I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, so the policy number I have is 0221.
[CUSTOMER][NEUTRAL] 6489 ML 7
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, [PII], [PII].
[AGENT][NEUTRAL] OK, 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.
[AGENT][NEUTRAL] And for inpatient, we cover up to $1000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim for inpatient services. Um, for outpatient services, we cover up to $200 per day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And for services um taking place in the office, we also cover up to $200 per day and that's for the coinsurance and the deductible, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] OK, not office visit not covered. OK, and um, can you tell me if he has um used any of the benefits you, you said, I'm sorry, the inpatient was $1000 per calendar year.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Right. And the um outpatient services and office visits, that's a daily benefit. So, let's see, for inpatients, no, he hasn't used any of his inpatient benefits this year.
[CUSTOMER][NEUTRAL] OK, and for the outpatient you said it was 200, have you used any on that?
[AGENT][POSITIVE] Um, it's a daily benefit.
[CUSTOMER][NEUTRAL] The what? I'm sorry?
[AGENT][NEUTRAL] So I
[AGENT][NEUTRAL] It's a daily benefit. Um, it won't be, he won't use it until the day of his appointment. It, cause it's a daily benefit, 200 per day.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][POSITIVE] OK, perfect. OK, [PII], that's all I needed thank you so much. Is there a reference number for this call?
[AGENT][NEUTRAL] I'm sure you can use my name and today's date. Um, is there anything else I can assist you with, [PII]?
[CUSTOMER][POSITIVE] No, that'll be all thank you.
[AGENT][POSITIVE] Mhm. Thank you again for calling APL. Have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.