AccountId: 011433970860
ContactId: e06c6a8a-dfdc-4b35-8232-b2c49cb0df7d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230600 ms
Total Talk Time (AGENT): 90583 ms
Total Talk Time (CUSTOMER): 75907 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/2025/01/23/e06c6a8a-dfdc-4b35-8232-b2c49cb0df7d_20250123T16:05_UTC.wav
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[AGENT][NEUTRAL] ACL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, can I verify benefits for a patient?
[AGENT][NEUTRAL] Yes ma'am, you can verify benefits. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] [PII]. My name is [PII].
[AGENT][POSITIVE] Thank you so much for that information.
[AGENT][NEUTRAL] And you said your name was [PII]. Can you spell that for me, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry, my name is spelled [PII] My name is [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you, Ms. [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then the policy number, please?
[CUSTOMER][NEUTRAL] 01914405ML8
[AGENT][POSITIVE] Thank you, let me look that up.
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy and his effective date is [PII], and this is just to verify coverage. It's not a guarantee of payment. He has a supplemental insurance policy that's billed secondary to the primary, and it helps with deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] He has an inpatient benefit amount of $1000 per calendar year and he also has an outpatient benefit amount of $250 per calendar day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so he has a 250 per per calendar date. He has 250.
[CUSTOMER][NEUTRAL] Um, coverage.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, per calendar day.
[CUSTOMER][NEUTRAL] The calendar date for outpatient surgery.
[AGENT][NEUTRAL] Well, it's for deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] For co-pay, deductible and coinsurance, correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and um what's the effective date you said?
[AGENT][NEUTRAL] The effective date was [PII].
[CUSTOMER][POSITIVE] Alright, you're welcome. OK, bye.
[AGENT][NEUTRAL] Wait, I'm so sorry. His effective date is, let me go back to it.
[CUSTOMER][NEUTRAL] have
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So he has 250 coverage per calendar date for outpatient surgery for co-pays, deductible and co-insurance.
[AGENT][POSITIVE] Right, for co-pay, deductible and co-insurance, you're correct.
[CUSTOMER][NEUTRAL] OK, can I get a um reference number for the call?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] You can use my name, [PII], in today's date.
[CUSTOMER][POSITIVE] Thank you so much. You have a wonderful day.
[AGENT][POSITIVE] You too. Thank you for calling APL. You have a good day also.
[CUSTOMER][POSITIVE] Thank you bye.
[CUSTOMER][NEUTRAL] the other one.
[AGENT][NEUTRAL] Bye-bye.