AccountId: 011433970860
ContactId: c7e2a9e8-1496-47da-9d16-eb44cd14ceea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 144800 ms
Total Talk Time (AGENT): 80346 ms
Total Talk Time (CUSTOMER): 50361 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/c7e2a9e8-1496-47da-9d16-eb44cd14ceea_20250227T17:21_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, my name's [PII]. I'm calling from Murdoch Surgery Center trying to get um eligibility and benefits on a patient coming in.
[AGENT][POSITIVE] Sure, I can check eligibility benefits for you. At least, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is 234-063-2.
[AGENT][NEUTRAL] OK. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Um, his name is [PII], and his date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, at least. So this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to check the uh outpatient benefit.
[CUSTOMER][NEUTRAL] Yes, we're an ASC not related to a hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. Uh, so the outpatient benefit is on a per calendar day basis, so it would pay up to $1000 max per calendar day.
[CUSTOMER][NEUTRAL] 1000 per.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is that for everybody or is that just for the facility itself?
[AGENT][NEUTRAL] Uh, that's just for him so daily, uh, he could claim up to $1000 so it's not per facility, it's per day. So if he were to go to multiple facilities in a single day, um, it would pay out up to that much depending on who filed the claims first.
[CUSTOMER][NEUTRAL] Oh, OK, it's one of those, OK, got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, and I'm sorry you said your name is [PII]?
[AGENT][NEUTRAL] Yeah, [PII]
[CUSTOMER][NEUTRAL] Alright, and do you give a reference number for the call?
[AGENT][NEUTRAL] Mhm, it would just be my first name, last initial, and today's date, uh, so my last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] Alright, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.