AccountId: 011433970860
ContactId: c70c255f-db3c-41ed-bae9-15d009a9ac9c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181289 ms
Total Talk Time (AGENT): 92866 ms
Total Talk Time (CUSTOMER): 76787 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/c70c255f-db3c-41ed-bae9-15d009a9ac9c_20250226T16:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Bone and Joint Clinic in [PII], and I need to get benefits for a specialist office visit, please.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with benefits on a patient. Can you please give me your call back number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth [PII]. Policy number is 02460661.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I guess we're in network with this policy. I'm not real sure.
[AGENT][NEUTRAL] Right. Um.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] I'll give you the benefit information. Um, I do show that [PII] have an active policy. His effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And he can use this card anywhere he wants to. It's uh, and this is just to verify his benefits. It's not a guarantee of payment. This is a supplemental policy. It's a gap insurance that helps with deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, so we'll be good, that's perfect.
[AGENT][NEUTRAL] Yes, and he has an benefit amount of $5750 and then he also has an outpatient benefit amount per calendar year of $4750 to go towards the deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, alrighty, and do we have a he has no co well this picks up the copays up to that, correct?
[AGENT][NEUTRAL] Right, up to 4750 for outpatient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, up to 4500 you said?
[AGENT][NEUTRAL] 750.
[CUSTOMER][NEUTRAL] 750.
[CUSTOMER][POSITIVE] Alrighty thank you so much and do we have a call reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name it's [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you so much for your help.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I hope you have a great rest of your day. We're almost to the end of the week, so hang in there.
[CUSTOMER][POSITIVE] Thank you, you too. I know that's what we're talking. This is [PII].
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] If there's such a thing, if not, we're gonna invent it.
[AGENT][NEUTRAL] Right, we've got it, we've got it on the calendar now it's invented.
[CUSTOMER][POSITIVE] That's it. It's a minute. You have a great day.
[AGENT][POSITIVE] You too and thanks for calling APL Ms. [PII]. Bye bye.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm bye bye.