AccountId: 011433970860
ContactId: 0c4a9a34-01b8-4c1e-a48d-628ab61f6ba3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217119 ms
Total Talk Time (AGENT): 97885 ms
Total Talk Time (CUSTOMER): 67363 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/0c4a9a34-01b8-4c1e-a48d-628ab61f6ba3_20250109T14:12_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Nicholas Children's Hospital. And I would like to check the patient's eligibility and benefits.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number and the policy number and I'll be and then the member's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, sure.
[CUSTOMER][NEUTRAL] Sure. The callback is [PII].
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] 02348137 M as in Mike, L as in Lima, and the number 8.
[AGENT][NEUTRAL] Thank you, [PII]. And could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] You're calling to verify inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] Outpatient?
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active. This member has outpatient benefits.
[AGENT][NEUTRAL] Of $2000 per calendar year and this is not a guaranteed benefit it's just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] And what's the effective date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the plant type?
[AGENT][NEUTRAL] This is the gap insurance.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] This is the gap insurance. It's not a primary. It's a gap insurance to the primary, which is this the the deductible co-pay and co-insurance to the primary insurance.
[CUSTOMER][POSITIVE] Yeah, OK. Thank you.
[CUSTOMER][NEUTRAL] And uh is there any uh group number and the group name?
[AGENT][NEUTRAL] Yes, there is.
[CUSTOMER][NEUTRAL] Can I have that?
[AGENT][NEUTRAL] The member's group number is 17328. That's 17328 and the group name is Temple Beth.
[AGENT][NEUTRAL] So long.
[CUSTOMER][NEUTRAL] Could you please spell that?
[AGENT][NEUTRAL] Which one do you want me to spell the entire three letters, 3 words or the last word?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The 3 words.
[AGENT][NEUTRAL] So it's Temple
[CUSTOMER][NEUTRAL] Temple, OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry, I missed the spelling.
[AGENT][NEUTRAL] What spelling did you miss the last word or?
[CUSTOMER][NEUTRAL] The last word, yes, the last word.
[AGENT][NEUTRAL] [PII], [PII] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, thank you so much. And uh is there any co-insurance on the co-pay?
[AGENT][NEUTRAL] No, this is a this is a gap insurance to the primary. We assist with the deductible, co-pay and co-insurance for the primary insurance.
[CUSTOMER][NEUTRAL] OK. Uh, could you please tell me your name?
[AGENT][NEUTRAL] [PII], and today's day, [PII] is a reference because we don't provide reference numbers unfortunately.
[CUSTOMER][POSITIVE] Yeah, thank you so much and have a wonderful day and uh take care.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day bye.