AccountId: 011433970860
ContactId: c1610948-5a99-41e1-947e-bfe513f9475e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230830 ms
Total Talk Time (AGENT): 79780 ms
Total Talk Time (CUSTOMER): 59766 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/c1610948-5a99-41e1-947e-bfe513f9475e_20250514T19:37_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, this is [PII] at the Orthopedic Center. I am calling to check if the patient has surgery benefits and what those are, please.
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with the surgery benefits, and may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, my direct line is [PII].
[CUSTOMER][NEUTRAL] And the policy number is 01905619.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And can you verify the member's first, um, yes, the member's first and last name and date of birth, I'm sorry.
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And do you mind if I place you on just a brief hold while I look at the benefits for surgery?
[CUSTOMER][POSITIVE] Oh, that's fine. Thank you.
[AGENT][NEUTRAL] You're welcome. And then also, would this be an inpatient or outpatient surgery?
[CUSTOMER][NEUTRAL] Mm, let me see if I can tell that.
[AGENT][NEUTRAL] Well, will she be admitted?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I'm trying to find out what they've done on that, no, outpatient.
[AGENT][NEUTRAL] Outpatient, OK.
[AGENT][NEUTRAL] Is there a deductible? All right, hold on one moment for me, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] All right, thank you so much for holding. I apologize for the wait. So the outpatient benefit um for the calendar year is $4500 per person.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] There is an outpatient deductible of $500 per person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that does include um surgery in a hospital facility or hospital outpatient facility or freestanding um outpatient surgery center.
[CUSTOMER][NEUTRAL] OK. Has any of that been met?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Has any of that 500 been met?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] She's met $50 so she still has $450 to meet for the year.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][POSITIVE] All right. That sounds good. Um,
[CUSTOMER][NEUTRAL] I don't think if I need to ask anything else.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] No, I think I'm actually good. Uh, thank you, [PII]. I appreciate your time. Have a wonderful day.
[AGENT][POSITIVE] You're very welcome. You also, and thanks for calling APO Christy. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Bye.