AccountId: 011433970860
ContactId: cbe28735-8f72-488a-9cb6-6fb10ac360c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246850 ms
Total Talk Time (AGENT): 116699 ms
Total Talk Time (CUSTOMER): 67370 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/cbe28735-8f72-488a-9cb6-6fb10ac360c1_20250409T21:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hello, I'm calling from Doctor [PII]'s office. I need to go with benefits please for a patient.
[AGENT][POSITIVE] OK, I can help you with better benefits.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me get the, the [PII], can you spell Miss [PII]'s last name for me, please? [PII]?
[CUSTOMER][NEUTRAL] It's, it's [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your name and your callback number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes, it's [PII] and that's [PII].
[AGENT][NEUTRAL] Thank you. And then may I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is 2544964. [PII] 92757.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick so I can get the benefits and eligibility for you.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is just to verify his benefits. It's not a guarantee of payment, and this is a supplemental policy that's billed secondary to his primary insurance. It helps with deductible, co-pay, and co-insurance. He has an inpatient benefit amount of $2500.
[AGENT][NEUTRAL] And then he also has an outpatient benefit amount of $1250 per calendar year.
[CUSTOMER][NEUTRAL] OK, so the last time that I called they were giving me an estimate that of remaining funds. Let me go into his account. They said remaining funds available was $1,153.60 76 cents. Is that what's still remaining, or is there another amount that's remaining?
[AGENT][NEUTRAL] And let me check for you real quick.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so for his outpatient benefits, let me add those up he's used a little bit of that he's not.
[AGENT][NEUTRAL] Patient.
[CUSTOMER][NEUTRAL] He's not what?
[AGENT][POSITIVE] He's not used anything for inpatient, he's only used his outpatient benefits and I'm adding that total up for you now.
[CUSTOMER][NEUTRAL] OK, so then, so then the amount that I was given in February is wrong, that's remaining.
[AGENT][POSITIVE] I'm good
[CUSTOMER][NEUTRAL] Remain remaining is $1,153.76.
[AGENT][NEUTRAL] A total for you here
[AGENT][POSITIVE] OK, I'm gonna get that total for you here in just a minute.
[AGENT][NEUTRAL] And you're wanting outpatient, is that correct?
[CUSTOMER][NEUTRAL] Yes, I just need to know what's the remaining.
[AGENT][NEUTRAL] Yes ma'am, I understand.
[AGENT][NEUTRAL] You have to give me just a minute just to subtract it real quick.
[AGENT][NEUTRAL] His remaining at this time is $1,002.
[CUSTOMER][NEUTRAL] OK, so it's $1,0002 no cents?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, great. So let me have a reference number please thank you.
[AGENT][NEUTRAL] Yes ma'am. You can use my name [PII] at today's date.
[CUSTOMER][POSITIVE] OK great thank you [PII] bye bye.
[AGENT][POSITIVE] You're welcome, [PII]. Bye-bye. I hope you have a wonderful night. Thanks for calling APL.
[CUSTOMER][POSITIVE] Alright thanks bye.
[CUSTOMER][POSITIVE] Likewise bye bye. You're welcome bye.
[AGENT][NEUTRAL] Bye bye.