AccountId: 011433970860
ContactId: 0724075c-410e-4fb8-836f-1d802a36de2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268239 ms
Total Talk Time (AGENT): 119531 ms
Total Talk Time (CUSTOMER): 115198 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/0724075c-410e-4fb8-836f-1d802a36de2f_20250328T19:57_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hello Miss this is [PII]. I'm calling from my primary doctor in [PII], and we have a patient.
[CUSTOMER][NEUTRAL] Uh, he has been a couple of times this year and our system it shows that he has a secondary like a supplemental, uh, insurance with APL, but we try to verify like the, um, you know, the if it's active or not through the page but it's not recognized our credentials and not the patient account number so I don't know if you can help me with that please.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All, all verification has to be by mail, Ms. [PII]. I mean, not by mail, by phone, um, but I can go ahead and get eligibility information for this number. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it's going to be [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. And um may I have the name of the facility you're calling from for my notation?
[CUSTOMER][NEUTRAL] Yes, it is Broward Health, and the name of the doctor is [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, it says here, um, I don't know which one gave you, uh, in the card it said in hospital benefits cert number and then it said outpatient benefit cert number.
[AGENT][NEUTRAL] Outpatient.
[CUSTOMER][NEUTRAL] OK, it's going to be 025.
[CUSTOMER][NEUTRAL] 689.
[CUSTOMER][NEUTRAL] 94.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] Thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, his name is [PII], and his date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK, so, um, Mr. [PII] has a secondary supplemental plan to the major medical with us, and the effective date is [PII] and it is active at the moment. And let me see if it covers all, bear with me. Um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You said uh since [PII], right?
[AGENT][NEUTRAL] Um, let me go back. Um, yes, [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so this one doesn't cover in-office procedures or visits. This one is only for outpatient facilities like ER, urgent care, diagnostic centers, surgery centers. Those are the ones that are covered under the outpatient maximum. And then we have an inpatient which is hospitalization.
[AGENT][NEGATIVE] But it doesn't cover anything in office.
[CUSTOMER][NEUTRAL] OK, so basically it's only covered at sites appointment right on sites appointment.
[AGENT][NEUTRAL] It's basically outpatient facilities like ER hospital or outpatient facility for surgery, a surgery center, a diagnostic center, um, those type of places.
[CUSTOMER][MIXED] OK, but not like in this case a regular visit with her with his PCP.
[AGENT][NEUTRAL] No PCP, no specialist.
[CUSTOMER][POSITIVE] Oh, OK, perfect. OK, thank you, miss. Can you provide me please a reference number?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Yes, your name, please?
[AGENT][NEUTRAL] Sure. That's [PII].
[CUSTOMER][NEUTRAL] So [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK perfect and the initial of the last name is [PII], right?
[AGENT][NEUTRAL] [PII], correct. Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, miss, OK, thank you for the information.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.