AccountId: 011433970860
ContactId: 0909605c-8c40-450f-ac30-6a79957f9ed9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326029 ms
Total Talk Time (AGENT): 113397 ms
Total Talk Time (CUSTOMER): 109032 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/0909605c-8c40-450f-ac30-6a79957f9ed9_20250516T21:28_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII] and I'm calling from CHI Saint Luke's Memorial Hospital. I'm calling for a mutual patient who'll be having an ultrasound procedure with us on Monday, and uh she provided me the, or she said that she has an APL uh insurance as a secondary, and I would like to confirm the benefits for it.
[AGENT][POSITIVE] OK [PII] I can help you with eligibility and benefits for our member. What is your callback number sir just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Yep, our callback number is [PII] option number 3.
[AGENT][NEUTRAL] OK, and then what is the member's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, I'm calling for patient uh [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII]?
[CUSTOMER][NEUTRAL] Her policy number is 024.
[CUSTOMER][NEUTRAL] 51481.
[AGENT][NEUTRAL] OK, let me look Ms. [PII] up real quick.
[AGENT][NEUTRAL] Alright, I do
[AGENT][NEUTRAL] So that [PII] does have an active policy with us. The effective date of her policy is [PII].
[AGENT][NEUTRAL] This is just to verify her benefits. It's not a guarantee of payment. She does have a supplemental insurance policy that helps with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] Uh, she has, uh,
[AGENT][NEUTRAL] Oh, let's see.
[AGENT][NEUTRAL] Let me pull in her actual policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She has an outpatient benefit amount per occurrence of $250.
[CUSTOMER][NEUTRAL] Sorry, how much again was that?
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] It it's an outpatient per occurrence benefit of $250.
[CUSTOMER][NEUTRAL] That is $250 right?
[AGENT][NEUTRAL] Yes, that supports deductible copay or co-insurance.
[CUSTOMER][NEUTRAL] OK, um, I just wanna make sure this is per visit or for uh per annual year?
[AGENT][NEUTRAL] Per occurrence, per visit.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] OK, and how about the uh authorization requirement for an ultrasound? Will it require an authorization?
[AGENT][NEUTRAL] No, sir, because this is not the major medical insurance.
[CUSTOMER][NEUTRAL] Right, got it OK and you did mention that this is a supplemental plan, right?
[AGENT][NEUTRAL] Yes sir it's billed secondary to the primary.
[CUSTOMER][NEUTRAL] Got it. OK, alright, um, by the way, ma'am, do you have the, uh, claims mailing address?
[AGENT][NEUTRAL] Yes, sir. It's going to be [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Just to make sure the claims address again is [PII].
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][POSITIVE] Got it, thank you so much. I think this is everything that I needed to know. um, may I have your name one more time?
[AGENT][NEUTRAL] Yes, my name is [PII]
[AGENT][NEUTRAL] And you can use my name and today's date for your reference number.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Thank you so much Miss [PII]. If you don't mind me asking, may I also include your last name initial?
[AGENT][NEUTRAL] Yes, it's A
[CUSTOMER][POSITIVE] OK, well, that is it, Ms. [PII]. uh, thank you so much for your assistance. You've been a great help. Have a great day ahead and uh stay safe.
[AGENT][POSITIVE] You too, [PII] thank you for calling APL and you have a wonderful weekend.
[AGENT][NEUTRAL] Bye-bye, sir.
[CUSTOMER][NEUTRAL] You too bye bye.