AccountId: 011433970860
ContactId: e7960fad-f266-406f-adbb-46db939fdd85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153580 ms
Total Talk Time (AGENT): 93477 ms
Total Talk Time (CUSTOMER): 57541 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/e7960fad-f266-406f-adbb-46db939fdd85_20250206T16:33_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from a provider's office. I need benefits on a patient please.
[AGENT][NEUTRAL] Sure, I can assist you with benefits, and may I have your name?
[CUSTOMER][NEUTRAL] [PII], I'm sorry I didn't get yours.
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome, Miss [PII]. And may I have a callback number and the name of the facility or place you're calling from?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Yeah, call back number is [PII]. I'm calling from Doctor [PII] office.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. It's uh 01611752 ML 8.
[AGENT][NEUTRAL] All right, thank you, Miss [PII]. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII], date of birth [PII].
[AGENT][NEUTRAL] Mm, thank you. And you need benefits for the office procedures or office visit or both?
[CUSTOMER][NEUTRAL] Uh, outpatient surgical procedure, I'm pretty sure that doesn't cover office visit, right?
[AGENT][NEUTRAL] I can check. And the surgery is gonna take place in the office or it's gonna go into an outpatient facility free standing?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No outpatient is ambulatory or outpatient hospital, not the office outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. OK. Got you. OK. All right. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the outpatient maximum is 1500 per covered person per calendar year, and this includes office procedures, but it doesn't include the office visit.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, has he met any of the 1500?
[AGENT][NEUTRAL] I can check for you. Let's see.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] As of today, he has not used his benefits for [PII], so he still have the full amount available.
[CUSTOMER][POSITIVE] Perfect. All right, that's all I need. Thank you so much for your help. You have a good day. Bye-bye. Yes.
[AGENT][POSITIVE] You're welcome. You as well, Miss [PII]. Thank you for calling.