AccountId: 011433970860
ContactId: bc11a30f-eb20-4ec3-a78d-2c6a63164167
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204759 ms
Total Talk Time (AGENT): 113439 ms
Total Talk Time (CUSTOMER): 77537 ms
Interruptions: 3
Overall Sentiment: AGENT=1.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/bc11a30f-eb20-4ec3-a78d-2c6a63164167_20250224T18:08_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] Hey, uh, my name is [PII] calling from Piedmont Hospital, calling um to try to verify benefits for a patient who's scheduled for outpatient surgery.
[AGENT][POSITIVE] OK, sure, I can assist you with that patient benefits, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure [PII].
[AGENT][NEUTRAL] Alright, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] I have 01953628.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, that's definitely not who I pulled. Let me have that number one more time, Miss [PII].
[CUSTOMER][NEUTRAL] Uh-huh 01953628.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me check one more time.
[AGENT][NEUTRAL] Oh, that's not pulling that member. Do you have the copy of the card?
[CUSTOMER][NEUTRAL] Yeah, let me pull that up real quick.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It says policy number 01954628.
[AGENT][NEUTRAL] 46. OK, let me change that 32 4.
[CUSTOMER][NEUTRAL] Ah, I see somebody typed it in wrong here. Thank you fix that on 5525462.
[AGENT][POSITIVE] You're welcome. It's OK.
[AGENT][NEUTRAL] OK, yeah. Now we have [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK, thank you and let me have that date of birth one more time now that I have [PII] pulled up.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] All right, perfect. Thank you, Ms. [PII]. All right, and 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 plans to the major medical and we have an outpatient maximum of 1500 per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Have they used anything of that $1500?
[AGENT][POSITIVE] It's a daily benefit.
[CUSTOMER][NEUTRAL] Oh, daily, sorry, I, you did say that. OK, so this is like a limited benefit plan.
[AGENT][POSITIVE] Yeah, it's OK, no problem.
[AGENT][NEUTRAL] It is, um, it will not pay 100%. It will pay, um, up to the maximum of the policy, um, but it's to help with the high deductibles, co-payment, and co-insurance. Yeah, but if it's more than $1500 it's just gonna pay that 1500.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] I got you and do y'all require authorization for surgery?
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] No authorization is not gonna be required because we're just a secondary.
[CUSTOMER][NEUTRAL] OK, um, is there a reference number for our call?
[AGENT][NEUTRAL] We don't have reference numbers, but you can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][POSITIVE] Uh, yeah, and your last name initial would be great.
[AGENT][NEUTRAL] Sure. That's [PII]. Last [PII] is [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome, Ms. [PII], and thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you