AccountId: 011433970860
ContactId: f990c782-60c2-4594-96a4-05fe88907393
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 297119 ms
Total Talk Time (AGENT): 108487 ms
Total Talk Time (CUSTOMER): 74467 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/f990c782-60c2-4594-96a4-05fe88907393_20250124T20:42_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office. Could you please add know eligibility and benefits?
[AGENT][NEUTRAL] Yes, I can help you with eligibility and benefits um can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sure. It is Columbia Gastro Associates.
[AGENT][NEUTRAL] OK, thank you and what is your callback number just in case our was disconnected?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] Thank you and then what's the patient's name?
[CUSTOMER][NEUTRAL] One moment, please.
[CUSTOMER][NEUTRAL] Patient first name is [PII].
[CUSTOMER][NEUTRAL] And last name is [PII].
[AGENT][NEUTRAL] OK. And then what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] One moment, please.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And what's the patient's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02584155.
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK I do show that [PII] does have an active policy.
[AGENT][NEUTRAL] Her effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify coverage. It's not a guarantee of payment. She has a supplemental insurance policy that is billed secondary to the primary. It's a gap insurance that helps with deductible, co-pay and co-insurance only. She has an inpatient benefit amount.
[AGENT][NEUTRAL] Of
[AGENT][NEUTRAL] $3000 and then she also has an outpatient benefit amount of $3000 per calendar year.
[CUSTOMER][NEUTRAL] OK. Uh, may I know this patient is terminated or not active?
[AGENT][NEUTRAL] They are active.
[CUSTOMER][NEUTRAL] OK. Uh, could you please help me with the
[CUSTOMER][NEUTRAL] Deductible amount.
[AGENT][POSITIVE] She has a benefit amount per.
[CUSTOMER][NEUTRAL] For in network.
[AGENT][NEUTRAL] She has a benefit amount per calendar year of $3000 to help with deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] OK. May I know if there is any out of pocket amount?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. May I know, uh, is there any met amount patient has been met?
[AGENT][NEUTRAL] Let me look and see if they've met anything if they've used anything this year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Nothing has been used this year.
[CUSTOMER][POSITIVE] OK. Thank you so much. May I know this number required the authorization?
[AGENT][NEUTRAL] The members what ma'am?
[CUSTOMER][NEUTRAL] Required authorization or not.
[AGENT][NEUTRAL] No, it does not because this is not the major medical.
[CUSTOMER][NEUTRAL] May I know the supplement plan?
[AGENT][NEUTRAL] Yes, this is a supplement plan.
[CUSTOMER][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] Could you please spell out for me?
[AGENT][NEUTRAL] T O R Y.
[CUSTOMER][POSITIVE] Thank you so much. Could you please help me with call reference number?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for providing me the information. Have a great day.
[AGENT][POSITIVE] Thank you. You also, Ms. [PII]. You have a good weekend.
[AGENT][POSITIVE] Thanks for calling APL.
[CUSTOMER][NEUTRAL] Bye.