AccountId: 011433970860
ContactId: de760e9c-b66c-4c1b-b2ca-c22fc30f6df3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209360 ms
Total Talk Time (AGENT): 58157 ms
Total Talk Time (CUSTOMER): 77652 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/de760e9c-b66c-4c1b-b2ca-c22fc30f6df3_20250410T15:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII] and I'm calling from an ambulatory surgical center. I'm calling to check benefits on a patient.
[AGENT][POSITIVE] OK, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, that's gonna be [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And I'm sorry, what was your name again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII], thank you.
[CUSTOMER][NEUTRAL] And uh initial to the last name first initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Did you have the policy number of the patient?
[CUSTOMER][NEUTRAL] I do, uh, the policy number just one moment.
[CUSTOMER][NEUTRAL] That's gonna be 01843884 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And this is for outpatient benefits, correct?
[CUSTOMER][POSITIVE] Yes, that's right for ambulatory surgical center.
[AGENT][NEUTRAL] OK. This is not a guarantee of payment. It's a basic outline of the policy and let's see what he's got.
[AGENT][NEUTRAL] Um, today is a $5000 calendar year maximum payout.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Not another benefit for.
[CUSTOMER][NEUTRAL] And so this $5000 payout, is that like a per procedure?
[CUSTOMER][NEUTRAL] Or for the whole year in total?
[AGENT][NEUTRAL] Um, let's see, that is.
[AGENT][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] check
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEGATIVE] No, sorry.
[AGENT][NEUTRAL] OK, actually, sorry about that. That's incorrect. It is $500 per calendar day. So after primary pays, it will pay up to $500 per calendar day of whatever is left over, like co-insurance, um, deductible from the primary.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so what he has available as of today it goes towards $500.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] All right, and let me see if I need anything else.
[CUSTOMER][NEUTRAL] Um, for this kind of, uh, secondary insurance, there's no authorization, um, or in network kind of benefits, right? It's just basically, um, for the ambulatory.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] All right, [PII], do you have a reference number for this call by chance?
[AGENT][NEUTRAL] Uh, reference number is just my first name, uh, first initial to last name, and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thanks so much for your help today.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too goodbye.