AccountId: 011433970860
ContactId: 0833c3c0-7c5d-4da1-bfdf-7a12897e44eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222570 ms
Total Talk Time (AGENT): 109062 ms
Total Talk Time (CUSTOMER): 46517 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/0833c3c0-7c5d-4da1-bfdf-7a12897e44eb_20250221T20:20_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, I'm sorry, what was your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] calling from Inner County Hospital, and I'm trying to verify benefits for our patient.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], you only need benefits. You do not need eligibility also?
[CUSTOMER][NEUTRAL] Well they're active.
[AGENT][NEUTRAL] Mm, OK, so you do need both eligibility and benefits, is that correct? Yes, ma'am, I can help you. And what is your callback number please, [PII]?
[CUSTOMER][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] That number is 01807484.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] His name is um.
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this limited benefit plan, [PII]. It is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what type of benefit information are you needing for him today? Inpatient, outpatient or office benefits because again this is not major medical insurance, this is a limited benefit plan.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah it's office benefits.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEGATIVE] And there's no way we could get that faxed to us or email could I?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, and is this for an office visit, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this limited benefit plan for outpatient accident and sickness for a physician's office visit, the benefit is $75 per day and a maximum of 6 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] 60.
[AGENT][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] Per day, OK.
[AGENT][NEUTRAL] Yes ma'am, and then once you all have submitted your claim and we have processed it, we do have a portal [PII] that you should be able to check claim status in.
[AGENT][NEUTRAL] And our portal website is secured. [PII].
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][POSITIVE] OK all right thank you so very much.
[AGENT][POSITIVE] Well, you're very welcome. And is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] Um, no, ma'am.
[AGENT][POSITIVE] OK, well then thank you again for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Alright