AccountId: 011433970860
ContactId: c3fa2e3a-6503-4cc3-8142-0f3153951f3d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173830 ms
Total Talk Time (AGENT): 69533 ms
Total Talk Time (CUSTOMER): 57702 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/c3fa2e3a-6503-4cc3-8142-0f3153951f3d_20250328T13:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] with Advanced Orthopedics of Oklahoma. I am calling to try to verify benefits and eligibility on a patient, please. I'm sorry, what was your name?
[AGENT][NEUTRAL] Um, it's [PII], um, it's spelled [PII] Mhm.
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thanks, [PII]. Um, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] OK. And yes, ma'am, I can assist you with benefits. Um, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Sure it's 02579334.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and just let me advise you the verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] It's for an office visit.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to 3500 per calendar year, and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay is not covered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] It's not covered.
[CUSTOMER][NEUTRAL] OK, 3500 calendar year.
[CUSTOMER][NEUTRAL] Coinsurance deductible after primary pay copay not have they met any of their 3500?
[AGENT][NEUTRAL] Um, let's see, one moment.
[CUSTOMER][NEUTRAL] For this year, OK.
[AGENT][NEUTRAL] Um, no, ma'am. So far, nothing has been met this year.
[CUSTOMER][NEUTRAL] OK 9 minutes.
[CUSTOMER][NEUTRAL] Alright, that sounds good to me. [PII], is there a call reference number for today?
[AGENT][NEUTRAL] Um, yes, ma'am. So the reference number, you can use my name and today's date. Um, is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that is all. I appreciate your help.
[AGENT][POSITIVE] Yeah, thank you, [PII] for calling APL. You have a great weekend. Mm bye.
[CUSTOMER][POSITIVE] Thanks you too bye bye.