AccountId: 011433970860
ContactId: e5a8185a-840b-415d-88aa-0d80a9148bd6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157440 ms
Total Talk Time (AGENT): 69982 ms
Total Talk Time (CUSTOMER): 39803 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/e5a8185a-840b-415d-88aa-0d80a9148bd6_20250312T17:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm with the facility. I'm trying to check eligibility and the benefits for a patient having surgery.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] It's 01792094.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And if you could verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] Thank you for verifying that, [PII]. So we have the eligibility date and then the outpatient information for you. Uh, the effective date is [PII]. Policy is active at this time.
[AGENT][NEUTRAL] And the maximum outpatient benefit you did say outpatient facility, right?
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] OK, it's up to $5000 that's, it's a per calendar year benefit. Now the inpatient and outpatient benefit is a combined maximum of up to $5000 per calendar year, um, and of course any information provided is verification, not a guarantee of payment, um, currently I'm showing.
[AGENT][NEUTRAL] Let's see.
[AGENT][POSITIVE] There's been a few benefits paid out so far. I'll give you that figure in just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So currently a total of $1,899.41 has been used of the $5000.
[CUSTOMER][NEUTRAL] All right. Is there any authorization required?
[AGENT][NEUTRAL] Authorization is not required.
[CUSTOMER][NEUTRAL] So we just send this to you with the primary EOB?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. All right, that's what I need to know.
[AGENT][NEUTRAL] Alrighty, any other questions, Ms. [PII]?
[CUSTOMER][POSITIVE] That's all. You have a good day.
[AGENT][POSITIVE] Uh, you too, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Bye.