AccountId: 011433970860
ContactId: f4ad8f64-ab72-44f8-b8a4-37ccef2afb96
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272320 ms
Total Talk Time (AGENT): 139475 ms
Total Talk Time (CUSTOMER): 95978 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/f4ad8f64-ab72-44f8-b8a4-37ccef2afb96_20250318T15:19_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] Yes, hi [PII]. My name is [PII]. I'm calling from the outpatient center of Del Rey. I need to get benefit information for a patient.
[AGENT][POSITIVE] Well, [PII], it would be a pleasure to assist you with that, uh, benefits. What is the callback number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you. And the policy number for the patient, please.
[CUSTOMER][NEUTRAL] Uh, she gave me 02606702.
[AGENT][NEUTRAL] 0206. Could you mind repeating that? I think I messed it up. I apologize.
[CUSTOMER][NEUTRAL] No 02.
[CUSTOMER][NEUTRAL] 02606702
[AGENT][POSITIVE] You know what, I am so sorry. I am just botching this one up good. I apologize one more time I'm writing it down and I'm gonna get it right, I promise.
[CUSTOMER][NEUTRAL] OK, 02606702.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I don't know why. It just was one of, I apologize. I was having a moment.
[CUSTOMER][NEUTRAL] That happens to me all the time.
[AGENT][NEGATIVE] You're like, you know, you hear it, you know you're typing it. It's just not working right. I got it now.
[CUSTOMER][NEUTRAL] I get it
[AGENT][NEUTRAL] What is that patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Dream
[CUSTOMER][NEUTRAL] [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, thank you. Never heard that is the first name. That's interesting.
[CUSTOMER][POSITIVE] I like it.
[AGENT][POSITIVE] I do too. I'm just like, I like that.
[AGENT][NEUTRAL] OK, and I can help you with the eligibility and benefits for Dream. I'm showing that the policy is active. Effective date is [PII].
[AGENT][NEUTRAL] This is a secondary policy to her major medical.
[AGENT][NEUTRAL] And are there specific benefits you're needing?
[CUSTOMER][NEUTRAL] Uh, outpatient, um, for a, um, uh, endoscopy, so it's gonna be outpatient at an ambulatory surgery center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And diagnostic. OK, gotcha.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] I'm getting those benefits pulled up. Bear with me just one second.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And she does have outpatient.
[AGENT][NEUTRAL] Coverage
[AGENT][NEUTRAL] Now, her benefit amount is $8150 and that is for inpatient and outpatient combined.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she has the same time.
[CUSTOMER][NEUTRAL] So it covers deductible, it covers deductibles, co-insurance, and co-pays up to 8150.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, alright, um, and then so we bill um United and then we send the bill to APL and then you guys cover her deductible well what she's responsible for.
[AGENT][POSITIVE] That's right.
[AGENT][POSITIVE] Exactly, yes, ma'am.
[CUSTOMER][NEUTRAL] All right, and what would be the um the claims address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[AGENT][NEUTRAL] And the zip code is [PII]. You can also fax claims directly to our claims department.
[CUSTOMER][POSITIVE] All right awesome and do you have a reference number?
[AGENT][NEUTRAL] It's gonna be my name and today's date, and I spell my name [PII].
[AGENT][NEUTRAL] And also if you would please note here that all benefits given over the phone is a verification of coverage, not a guarantee of payment.
[CUSTOMER][POSITIVE] All right awesome thank you so much I appreciate your time.
[AGENT][POSITIVE] My pleasure to assist you with those benefits today and thank you for calling APLT. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thanks you too bye bye.
[AGENT][NEUTRAL] Bye-bye.