AccountId: 011433970860
ContactId: b997676b-f138-4abe-ad0a-bb2f4dac0279
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222160 ms
Total Talk Time (AGENT): 81084 ms
Total Talk Time (CUSTOMER): 95721 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/b997676b-f138-4abe-ad0a-bb2f4dac0279_20250528T13:23_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]. How are you?
[AGENT][POSITIVE] Good. How are you?
[CUSTOMER][NEUTRAL] Good, thank you. [PII], I'm calling um because I, a member just gave me his information. He's having surgery tomorrow, outpatient surgery, and I want to see what benefits he has available to use.
[AGENT][POSITIVE] All right, I'm happy to check benefits. What's the policy number?
[CUSTOMER][NEUTRAL] The policy number he gave me is 2611485.
[AGENT][NEUTRAL] Alright, let me pull that up. And then for documentation, can I get your first name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] What is the patient's name and date of birth?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] It's gonna be [PII]. So it's [PII] Last name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date is [PII]. We are the members secondary insurance, so this does cover deductible, co-pay, co-insurance, the primary does not.
[AGENT][NEUTRAL] And it looks like.
[AGENT][NEUTRAL] The outpatient benefit max for all.
[AGENT][NEUTRAL] Is 19,500. Individual max is 6500.
[CUSTOMER][NEUTRAL] OK, so patience out of uh patients amount is 19,500.
[AGENT][NEUTRAL] Right, for the family, that's their outpatient max. The individual outpatient max is 6500.
[CUSTOMER][NEUTRAL] OK. And then let me ask you, um, 6500 individual.
[CUSTOMER][NEUTRAL] In there. OK. And then um when it comes to
[CUSTOMER][NEUTRAL] The plan, is it under his spouse, [PII], or him?
[AGENT][NEUTRAL] No, he's a subscriber.
[CUSTOMER][NEUTRAL] OK, he is. OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. And then um the group number is 60801.
[AGENT][NEUTRAL] Um, that's our payer ID.
[AGENT][NEUTRAL] The group number on the plan for him is 27031.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. All right, [PII]. And then, um, will you be able to tell me how much he has available to use or that will be somewhere else?
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Let me see if they've used any anything.
[AGENT][NEGATIVE] Doesn't look like anything has been used thus far.
[CUSTOMER][NEUTRAL] Uh, perfect. OK. So he's gonna pay 0 for tomorrow. Awesome, OK, [PII], may I please have a reference number?
[AGENT][NEUTRAL] Mhm. Call references my name with today's date. My name again is [PII], which is [PII], last initial [PII], and then today's date.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Perfect thank you so much. I appreciate your help.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] You too. Thank you. Bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] 1000.