AccountId: 011433970860
ContactId: 0a8fc463-16be-43af-8ff9-461a5a756341
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275170 ms
Total Talk Time (AGENT): 124619 ms
Total Talk Time (CUSTOMER): 62025 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/0a8fc463-16be-43af-8ff9-461a5a756341_20250108T14:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How may I help you?
[CUSTOMER][NEUTRAL] Hi good morning I'm sorry you said your name is?
[AGENT][NEUTRAL] [PII] last initial is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Thank you. Hi, [PII]. My name is [PII], and I'm calling from Memorial Regional Hospital for
[CUSTOMER][NEUTRAL] Benefits and eligibility.
[AGENT][POSITIVE] Sure, sure, I can help you, [PII] with benefits and eligibility. May I please have your call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] On a patient.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I please have the policy certificate or member ID?
[CUSTOMER][NEUTRAL] 1422277 M as in Mary, L as in Larry, the number 7.
[AGENT][NEUTRAL] OK, thank you [PII]. Give me just one moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I please have you verify a patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is uh [PII].
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And can you tell me if you're needing inpatient or outpatient benefits today?
[CUSTOMER][NEUTRAL] This is going to be observation, um, hospital facility benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just give me one moment to pull up their policy.
[AGENT][NEUTRAL] And just to let you know there's a verification of coverage only, not a guarantee of payment.
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] I show the policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] OK, and this is a gap policy?
[AGENT][NEUTRAL] It is, yes, it's similar to a gap policy that's correct it is limited, uh.
[AGENT][NEUTRAL] Limited supplemental benefit medical expense plan, so this policy will work hand in hand with their major medical to cover co-insurance and or deductible amounts for services covered under the plan.
[AGENT][NEUTRAL] And you said it was gonna be uh observation, so do you want me to give you both in and outpatient?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mm, outpatient, just the outpatient would be just fine. Well, yes, you can give me both, that's fine.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Just one moment please.
[AGENT][NEUTRAL] So their outpatient benefit uh is a $2000 per covered person per calendar year for covered outpatient services.
[AGENT][POSITIVE] Um, and that patient benefit.
[AGENT][NEUTRAL] I believe it's just similar amount but.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] And so that inpatient benefit is also a $2000 per covered person per calendar year.
[AGENT][NEUTRAL] Um, and there is no deductible required for this plan for in or outpatient. Again, it will work hand in hand with their major medical to cover coinsurance and or deductible amounts up to their benefit maximum for services covered under the plan. Did you have any other questions?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] That that would be, that would be it. Is there a reference number or am I just using your name and uh today's date?
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Yes, that is the call reference number my name and today's date, that is correct.
[CUSTOMER][POSITIVE] OK great well thank you so much that's all I needed have a great day OK?
[AGENT][POSITIVE] You too, [PII]. Thank you so much for calling APL. I hope you have a great rest of your day and a great rest of your week.
[CUSTOMER][POSITIVE] Thank you. Mhm. You too. Bye-bye. Bye-bye.
[AGENT][POSITIVE] Thank you bye bye.