AccountId: 011433970860
ContactId: c93dc14a-d3d2-4130-ae7e-9c580b2a8dc8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190940 ms
Total Talk Time (AGENT): 80822 ms
Total Talk Time (CUSTOMER): 95278 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/c93dc14a-d3d2-4130-ae7e-9c580b2a8dc8_20250326T15:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Take the mute button off?
[AGENT][NEUTRAL] The mute button isn't on. Can you hear me?
[CUSTOMER][NEUTRAL] Oh yeah, I can hear you just fine. Can you not hear me?
[AGENT][NEUTRAL] I, I can now, it was silent in the beginning. How may I help you?
[CUSTOMER][NEUTRAL] Oh, that is weird. OK, and uh, my name is [PII]. I'm calling from a facility which is an ambulatory surgery center, and I need to find out. I know this is one of those plans that they have X amount of dollars and whatever to supplement the primary, so I'm just needing to get her benefits um for the year, you know, for, for my, uh, data service is going to be for 3.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, sure.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the benefits and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it's gonna be [PII].
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, I have 02052121.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm. Sure.
[AGENT][NEUTRAL] All right, here we go. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII]. And are you all considered outpatient?
[AGENT][NEUTRAL] I would have
[CUSTOMER][NEUTRAL] Well you're outpatient. It's an ambulatory surgery center, yeah.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] I'm sorry, I forgot you said that, my apologies. OK, so for outpatients, the benefit is up to $1000 per calendar year. Did you want me to see if she's used any?
[CUSTOMER][POSITIVE] It's all right. That's OK.
[CUSTOMER][POSITIVE] I certainly would that would be great.
[AGENT][NEUTRAL] Sure, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so so far for [PII], she hasn't used any of the benefits.
[CUSTOMER][POSITIVE] Awesome, and so that $1000 is that strictly just for the facility benefit or is that for everything for this year?
[AGENT][NEUTRAL] So that's for all of our outpatient expenses for the entire year, whichever claims come in first.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And then with this plan, there's no um
[CUSTOMER][NEUTRAL] What do you call authorizations or anything to that it's just a straight, you'll pick up whatever the balance is up to $1000.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, we pay towards the copay, deductible and co-insurance of covered charges after primary up to 1000.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] That's it, yeah, that's what I meant and then [PII], if I can get a reference number, I appreciate your time.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right, and have a good day. Mm bye-bye.
[AGENT][POSITIVE] You also, [PII], thanks for calling.