AccountId: 011433970860
ContactId: ed4a642d-e73c-4901-81a6-24bd47fb29e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202850 ms
Total Talk Time (AGENT): 81963 ms
Total Talk Time (CUSTOMER): 65882 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/ed4a642d-e73c-4901-81a6-24bd47fb29e5_20250417T15:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes ma'am, this is [PII] with Center One Surgery Center, and I'm needing to um find out if a patient does have uh surgical benefits with you guys.
[AGENT][NEUTRAL] OK, I can definitely check the coverage and see if there's surgical benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] 904652-2328
[CUSTOMER][NEUTRAL] And the number she gave me, she gave me an inpatient and outpatient ID number. We're an outpatient facility, so I guess the second one.
[AGENT][NEUTRAL] Well, the numbers are the same. The ML 7 or 8 at the end is different. I just need the numbers, that's the policy number.
[CUSTOMER][NEUTRAL] 02419.
[CUSTOMER][NEUTRAL] 189.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name is [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII]. And hold on one moment, I'm pulling up the benefits now to search for a surgical.
[AGENT][NEUTRAL] And you said you all are outpatient, right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So under outpatient, the policy would pay up to $500 per calendar day. That does include surgery in a hospital outpatient facility or freestanding outpatient surgery center.
[CUSTOMER][NEUTRAL] OK, so up to $500 a day for each individual, um.
[AGENT][NEUTRAL] Uh oh, I went in and out. Hello?
[CUSTOMER][NEUTRAL] Is it $500 a day for each individual person?
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] I'm here. Hold on one moment.
[AGENT][NEUTRAL] So yes, it's $500 per covered insured.
[CUSTOMER][NEUTRAL] Each insured.
[CUSTOMER][NEUTRAL] OK, and they have surgical benefits?
[AGENT][NEUTRAL] Yes, the $500 a day is the outpatient benefit, which includes surgery in an outpatient facility or freestanding outpatient center.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yep, that would be us outpatient.
[CUSTOMER][NEUTRAL] All right, that's all I needed and um can I just get a call reference number please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date and again, that's [PII] to my last name is [PII].
[CUSTOMER][POSITIVE] And then today's date alright perfect thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] All right, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you too. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.