AccountId: 011433970860
ContactId: fb93abb8-ba86-408d-a4e2-2b4c6c623390
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 341269 ms
Total Talk Time (AGENT): 136659 ms
Total Talk Time (CUSTOMER): 97215 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/fb93abb8-ba86-408d-a4e2-2b4c6c623390_20250228T16:08_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, hello, my name is [PII] from. I need to verify benefits services.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And my extension [PII].
[AGENT][NEUTRAL] And what's the name of the facility you're calling from?
[CUSTOMER][NEGATIVE] It's clearly expensive.
[AGENT][NEUTRAL] May I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, D as in David 45302593.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits. That's gonna be a number.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is the policy number D45302593.
[AGENT][NEUTRAL] So you don't have anything else besides that number?
[CUSTOMER][NEUTRAL] Uh, let me check the insurance card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, OK, so uh the policy number is 0251468.
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 9
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Mm, can you repeat that number because I didn't pull the list, so go ahead and repeat that number, the policy number.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Sure, it's uh 02514682.
[AGENT][NEUTRAL] 8, what is the last digit? I'm not getting that digit. What is the last digit? 2, number 2. OK.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] All right. And you said you need benefits today for what type of service, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, uh, for patient and I have a CD code for that.
[AGENT][NEUTRAL] OK. Uh, so is it like an office visit? Is it diagnostic imaging? What is it?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] It's a surgery done in office.
[AGENT][NEUTRAL] A what? I'm sorry?
[CUSTOMER][NEUTRAL] And for outpatient surgery which is done in office by a specialist.
[AGENT][NEUTRAL] Outpatient surgery in the office. OK. All right. OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage. And that's just a disclaimer. And this is one of our limited hospital indemnity policies. Um, for this one, if there is a surgery in office, we cover $125 which is a flat amount, that's $125.
[AGENT][NEUTRAL] And that's up to 2 per calendar year per covered person.
[CUSTOMER][NEUTRAL] Uh $175 right OK.
[AGENT][NEUTRAL] 125, 125.
[CUSTOMER][NEUTRAL] 14 125.
[CUSTOMER][NEUTRAL] And 2 visa you said per calendar year.
[AGENT][NEUTRAL] And it's gonna be 2 surgeries in office per covered person per calendar year, correct.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, uh, can you please confirm if the two remaining phones already used?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me see if he has used his one moment.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK, she has not used her benefits as of today, so she still have the full amount available.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much. That's all and uh is there observation required for this surgery?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No authorization is not required.
[CUSTOMER][NEUTRAL] OK, your name please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] And the first number of this call.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate your assistance. Have a great day. Bye for now.
[AGENT][POSITIVE] Mhm. You as well. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] OK