AccountId: 011433970860
ContactId: 0492233b-da84-464a-9580-4d68c050d045
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203229 ms
Total Talk Time (AGENT): 101239 ms
Total Talk Time (CUSTOMER): 102115 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/0492233b-da84-464a-9580-4d68c050d045_20250206T15:35_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] Good morning. So, my name is [PII] and I'm with Memorial Hospital Miramar. I was calling to verify eligibility for a patient that came into our ER. What information can I provide you?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. Uh, first, I'm gonna need a callback number just in case we get disconnected, Ms. [PII].
[CUSTOMER][NEUTRAL] uh [PII], it's [PII] and a callback number for me is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yes. 01297498 M as in Mary, L as in Larry, the number 8.
[AGENT][NEUTRAL] Thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] Date of birth is [PII]. She came into our ER on [PII].
[AGENT][POSITIVE] OK perfect.
[AGENT][NEUTRAL] [PII]. OK, perfect. Thank you. Let me see. All right, so we have um an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical. Do you need um benefit information as well?
[CUSTOMER][NEUTRAL] Well, I basically wanna know if this plan it will cover her um.
[CUSTOMER][NEUTRAL] Uh, ER visit because I, I understand that it's a gap, but she also has a Medicaid, so I wasn't sure if I should, you know, send it to the American Public Life or, you know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] OK. Yes, sure. All right. OK. And this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And we have a calendar year, well, it's gonna be a calendar day benefit. It's a daily benefit of $500 for outpatient service, including ER visits.
[CUSTOMER][NEUTRAL] I wasn't sure. Yeah.
[CUSTOMER][NEUTRAL] Oh OK, so keep it on the claim then alright no problem and it is like you said secondary.
[AGENT][POSITIVE] Mhm, correct. Mhm.
[AGENT][NEUTRAL] Yes. Now, it is secondary to the major medical. Let me check and see what the major medical on this number, OK?
[CUSTOMER][NEUTRAL] Yeah, I have it as Blue Cross and Blue Shield, so I verified that.
[AGENT][NEUTRAL] Mhm. Yes. Uh, Blue Cross. Oh yes, they changed this year. That is correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK, so you'll be secondary to Blue Cross.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and then it would be the Medicaid last. OK, no problem.
[AGENT][NEUTRAL] Yes, that's the treasury. OK. Yes.
[CUSTOMER][POSITIVE] Yeah, I got it OK.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Is there anything else?
[CUSTOMER][NEUTRAL] Is there a reference ID for this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] Yes, [PII], yes. Last initial [PII]
[CUSTOMER][POSITIVE] OK, I love it. It's so simple. thank you.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] Have a good have a good day.
[AGENT][POSITIVE] Oh yeah. That's about right.
[CUSTOMER][NEUTRAL] OK, bye bye.