AccountId: 011433970860
ContactId: cefa314f-c2fe-4d6d-9ee9-4686c9ad9643
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161389 ms
Total Talk Time (AGENT): 66957 ms
Total Talk Time (CUSTOMER): 56396 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/cefa314f-c2fe-4d6d-9ee9-4686c9ad9643_20250328T18:41_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am. I'm calling to verify benefits on a patient please.
[AGENT][NEUTRAL] Oh, OK, can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] [PII] [PII], that's the direct number.
[AGENT][POSITIVE] OK, thank you, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, it's showing 02243512.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And you needed benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, the patient has this listed as a secondary insurance, stated that it's supposed to cover at 100%, so I'm just verifying.
[AGENT][NEUTRAL] OK, uh, it's not a guarantee of payment basic outline of the policy. She's active and effective [PII]. Is this for like outpatient services or?
[CUSTOMER][NEUTRAL] Yes, ma'am. This is for outpatient services.
[AGENT][NEUTRAL] OK, let's see, let me pull that up real quick. Just give me one moment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um, so the outpatient benefit on this policy, um, which is a secondary policy, we will need the primary explanation of benefit filed, um, it pays $2550 per covered person per calendar year.
[CUSTOMER][POSITIVE] OK, perfect, because her responsibility is 1000. So that's perfect. That means you guys will pick it up.
[AGENT][NEUTRAL] But.
[AGENT][NEUTRAL] Yeah, so it is for, so is this like in an outpatient hospital services in an outpatient hospital?
[CUSTOMER][NEUTRAL] It's a facility. It's an outpatient facility.
[AGENT][NEUTRAL] OK, yeah. So, yes, based on this policy, it would coordinate and pick up up to the 2550.
[CUSTOMER][POSITIVE] Perfect. May I please get a reference number for this call and your name please?
[AGENT][NEUTRAL] Uh, reference number is just my first name, [PII], last initial [PII], today's date.
[CUSTOMER][NEUTRAL] Do, do you spell [PII] with [PII] or [PII]?
[AGENT][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] Got you. And I'm sorry, what was your last initial?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][POSITIVE] Thank you so much, Ms. [PII]. I appreciate it. You have a blessed weekend.
[AGENT][POSITIVE] Thank you. You as well.
[CUSTOMER][NEUTRAL] Bye bye.