AccountId: 011433970860
ContactId: d72bfc64-fc33-4b75-a78f-a1a1e980975e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241759 ms
Total Talk Time (AGENT): 97120 ms
Total Talk Time (CUSTOMER): 69249 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/d72bfc64-fc33-4b75-a78f-a1a1e980975e_20250304T18:00_UTC.wav
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[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] You hear me?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Nicola's Children's Ambulatory Surgery Center. I just wanted to get, um, benefits and eligibility on a patient that's going to have a procedure tomorrow.
[AGENT][NEUTRAL] I help you with benefits and eligibility. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], um, then [PII] for the last name and then my call back number is [PII].
[AGENT][NEUTRAL] OK. And Ms. [PII], what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK, the patient's name is [PII]. Date of birth is [PII], and I have the group number. Is that fine?
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you.
[CUSTOMER][NEUTRAL] It's gonna be 22294.
[AGENT][NEUTRAL] OK, let me look up that group.
[AGENT][NEUTRAL] And can you spell the member's last name for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, let me look real quick.
[AGENT][NEUTRAL] OK, and is the member a dependent?
[CUSTOMER][NEUTRAL] It's a family. It's a family.
[AGENT][NEUTRAL] OK, who is the um policy holder's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, I do show that address does have an active policy. The effective date of the policy is [PII], and let me give you that policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 1935546.
[CUSTOMER][NEUTRAL] OK, 1935546.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, perfect. And does the patient have a copay or anything?
[AGENT][NEUTRAL] Uh, this is just to verify benefits. It's not a guarantee of payment. So what it is is it's a supplemental insurance policy, a gap insurance that's billed secondary to the primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This policy helps with deductible copay and.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if the patient is inpatient, they have a calendar benefit amount of $7350 and then they also have a calendar year benefit for outpatient for $7350.
[CUSTOMER][NEUTRAL] OK, perfect. And what's the reference number for this call?
[AGENT][NEUTRAL] You can use my name it's and today's date.
[CUSTOMER][NEUTRAL] What's your name again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK then so.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] OK, perfect, you've been very helpful thank you so much.
[AGENT][POSITIVE] You're very welcome. I hope you have a good day and thanks for calling APL.
[CUSTOMER][POSITIVE] You too no problem thank you bye bye.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Bye bye now