AccountId: 011433970860
ContactId: 0e49f51d-d23f-48c8-98a3-6d4c579fbffe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178539 ms
Total Talk Time (AGENT): 80067 ms
Total Talk Time (CUSTOMER): 81711 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/0e49f51d-d23f-48c8-98a3-6d4c579fbffe_20250121T18:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Good afternoon. My name is [PII]. I'm calling from a provider's office. And I just need to check uh patient's eligibility, please.
[AGENT][POSITIVE] All right, I'm happy to check on eligibility today, [PII]. Do you have the policy number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh yes, let me give that to you.
[CUSTOMER][NEUTRAL] It is. This is a family plan, um.
[CUSTOMER][NEUTRAL] Would that be the
[CUSTOMER][NEUTRAL] The outpatient benefits certificate number?
[AGENT][POSITIVE] Yeah. Yeah, you can give me that. I can pull it with that.
[CUSTOMER][NEUTRAL] OK, that's
[CUSTOMER][POSITIVE] Awesome. That's uh 024733.
[CUSTOMER][NEUTRAL] 73
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][POSITIVE] All right, thank you so much. Let me just pull this up here. And do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 7000.
[AGENT][NEUTRAL] Thank you. What is the patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, this one is for [PII] [PII].
[AGENT][POSITIVE] Thank you so much. So the patient plan is active. The effective date is [PII]. We are the secondary insurance, so this is gonna cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][POSITIVE] Deductible copay, co-insurance of the Cross Blue Shield. Perfect. Uh, and at full, so the patient doesn't have any responsibility pretty much.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, this will cover anything that their primary does not. If it's for outpatient, it looks like their outpatient benefit max on this plan is a calendar day, which is $300.
[CUSTOMER][NEUTRAL] $300 that's their max.
[AGENT][NEUTRAL] Mhm. Per day.
[CUSTOMER][NEUTRAL] OK. OK. Um, so yeah, [PII] is scheduled to have a surgery on [PII].
[CUSTOMER][NEUTRAL] So that's how much I will be collecting, just $300?
[AGENT][NEUTRAL] That's the most for outpatient per calendar day if if they're not in the hospital over 18 hours, then yes, it would be outpatient.
[CUSTOMER][NEUTRAL] Yeah, it is outpatient. It's a small surgery.
[AGENT][NEUTRAL] OK, yeah. Yeah, so that's the most it would cover, OK?
[CUSTOMER][POSITIVE] Mhm perfect.
[CUSTOMER][POSITIVE] OK dokey thank you so much.
[AGENT][POSITIVE] You're welcome. Have
[CUSTOMER][NEUTRAL] Is there a reference number for a call?
[AGENT][NEUTRAL] Absolutely, that's gonna be my name with my last initial in today's date. My name again is [PII], that's [PII] Last initial to my name is [PII].
[CUSTOMER][POSITIVE] OK, and today's date, [PII]. Thank you so much for your help. Have a wonderful afternoon.
[AGENT][NEUTRAL] You too. Bye bye.
[CUSTOMER][POSITIVE] Thanks bye bye.