AccountId: 011433970860
ContactId: bd46bcc2-2350-4505-aef6-7332d1bbe775
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184630 ms
Total Talk Time (AGENT): 73442 ms
Total Talk Time (CUSTOMER): 66169 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/bd46bcc2-2350-4505-aef6-7332d1bbe775_20250527T14:02_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. This is Easy. How can I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII], and your name is spelled?
[AGENT][NEUTRAL] Um, [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Thank you [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] I'm reaching out because I have a patient get um scheduled for outpatient ambulatory surgery um and I wanted to verify the benefits for this patient under this plan.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] No problem, it's [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, policy number is showing to be.
[CUSTOMER][NEUTRAL] Um, 02500623 M as in Mary, L as in Larry.
[CUSTOMER][NEUTRAL] And it should be the number 8 for the outpatient.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], it's gonna be [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] and the policy is still active.
[AGENT][NEUTRAL] And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient outpatient benefits respiratory surgery. It's uh our facility is an outpatient um surgical center.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment, I'm waiting for the benefits to come up.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK. Yes, ma'am. For outpatient services, we cover up to 1000 per day and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] So it's 1000 per day after primary.
[CUSTOMER][NEUTRAL] Insurance copay, deductible, or out of pocket you said?
[AGENT][NEUTRAL] Yes, ma'am. Copay, co-insurance and deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And reference number for the and then the patient who has um the $1000 available to use because it's per day.
[AGENT][POSITIVE] Yes, it's a daily benefit. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, reference number for the call?
[AGENT][NEUTRAL] It will be my name and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that was all thank you.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you.