AccountId: 011433970860
ContactId: f6c5d42e-bdf7-4ac8-b5f6-e25c9b0c4618
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180000 ms
Total Talk Time (AGENT): 70519 ms
Total Talk Time (CUSTOMER): 102012 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/f6c5d42e-bdf7-4ac8-b5f6-e25c9b0c4618_20250401T12:20_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Calling from Randi Institute. I wanted to confirm benefits or I should say verify benefits and eligibility for a mutual member. Would you be able to assist me, please?
[AGENT][NEUTRAL] I can't. I missed your first name. Can you repeat, please?
[CUSTOMER][NEUTRAL] Oh yes, of course, it's [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and eligibility.
[CUSTOMER][NEUTRAL] Last initial is I go, I'm sorry.
[AGENT][NEUTRAL] OK, thank you [PII]. did you say this is for service in an office or outpatient setting?
[CUSTOMER][NEUTRAL] This would be for outpatient surgery being performed in a freestanding ambulatory surgical center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, if I can get the policy number and a good phone number, [PII].
[CUSTOMER][NEUTRAL] Of course, policy number is 02586655.
[CUSTOMER][NEUTRAL] And the member's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And the callback number?
[CUSTOMER][NEUTRAL] [PII]. Sorry, I missed that somewhere. You're welcome.
[AGENT][POSITIVE] Thank you, one moment. Mhm.
[AGENT][NEUTRAL] And you said the patient's name is [PII] with the date of birth of [PII]?
[CUSTOMER][NEUTRAL] Let's just verify that [PII], that's correct.
[AGENT][NEUTRAL] OK, I'm showing an effective date of [PII]. Policy is active at this time, and we have the outpatient benefit for you benefit for you. It's up to $500. That's per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Any information provided is verification.
[AGENT][NEUTRAL] Uh, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And currently I don't show any of that amount used at this time.
[CUSTOMER][NEUTRAL] And is that
[CUSTOMER][NEUTRAL] OK, no accumulations as of today, as of today, and is it just that $500 can be utilized towards his deductible or co-pays, co-insurance? It's a gap policy, isn't it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, deductible, co-insurance and or co-pay amounts, uh huh.
[CUSTOMER][NEUTRAL] So that.
[CUSTOMER][POSITIVE] OK perfect and he is up to $500. Perfect, thank you so very much, [PII]. If I could just get a reference oh and um since there's no authorization required, correct? I should ask you that.
[AGENT][NEUTRAL] No authorization is required and you'll use my name and today's date as reference for today's call. It's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, NYA first initial last name is [PII]. Anything else, [PII]?
[CUSTOMER][NEUTRAL] Um, just go back for one second when I had asked you, is there any authorization required? Did you say yes?
[AGENT][NEUTRAL] I say that no authorization is required.
[CUSTOMER][POSITIVE] Oh there was OK. That's what I was. I thought I had heard. Yes, that's what I was like, oh, let me just backtrack for a minute. OK, perfect, [PII]. I thank you so very much. I wish you a beautiful day.
[AGENT][NEUTRAL] Same to you thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you, thank you, bye bye.