AccountId: 011433970860
ContactId: ea2cddb5-595f-482e-a4b8-f0133b964d9b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207830 ms
Total Talk Time (AGENT): 67954 ms
Total Talk Time (CUSTOMER): 92491 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/ea2cddb5-595f-482e-a4b8-f0133b964d9b_20250213T15:34_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. I'm with Houston Premier Surgery Center and I'm trying to get some information on a patient's policy as far as the outpatient surgery um in network, and I'm also trying to see what type of plan is this.
[AGENT][NEUTRAL] OK, well I prefer.
[CUSTOMER][NEUTRAL] That they have with you all.
[AGENT][NEUTRAL] OK, well, I can verify benefits and or eligibility for you and your name is?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And Ms. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] The policy number is going to be one second it's gonna be 01947017.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes ma'am, it's gonna be [PII].
[AGENT][NEUTRAL] OK, thank you, [PII], and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is going to be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, uh, so effective date of [PII], policy is active, and the type of policy she has with our company is a secondary supplemental, uh, plan is used to help with primary deductible, co-pay or co-insurance for outpatient or in-hospital services.
[CUSTOMER][NEUTRAL] Secondary supplemental.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So she doesn't have like a PPO plan or anything like that with y'all.
[CUSTOMER][NEUTRAL] And let me look because she sent me a card we're just trying to verify because she's saying that we should be in network with you all.
[AGENT][NEUTRAL] Well, we don't have a network, um, but it would depend on if you're a network with her major medical, but we don't have a network with our company.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] So it depends on if we're in network with the uh who is this uh United Healthcare.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I'm just writing down it. It's a secondary supplementary.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And she was asking what did she have a PPO plan with you all? I know.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Why she was that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] She, what is the 5000 for with you all?
[AGENT][NEUTRAL] Um, that's her benefit Max. Uh, is this for outpatient or in hospital?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Uh, that's our benefit max per calendar year for outpatient.
[CUSTOMER][NEUTRAL] And the deductible she has is a $250.
[AGENT][NEUTRAL] Yes, ma'am. So once she's met that $250 deductible, then we pay up to $5000.
[CUSTOMER][NEUTRAL] I think you
[CUSTOMER][NEUTRAL] OK, and I think that's it for today.
[CUSTOMER][POSITIVE] OK, thank you so very much for the call.
[AGENT][POSITIVE] Uh, yes, ma'am, and thank you for calling APL Ms. [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye.