AccountId: 011433970860
ContactId: 0e8be51a-97ec-4ea2-9c27-47969d9f7b27
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206679 ms
Total Talk Time (AGENT): 95439 ms
Total Talk Time (CUSTOMER): 62864 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/0e8be51a-97ec-4ea2-9c27-47969d9f7b27_20250609T16:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII] calling from Memorial Hospital Memorial Regional Hospital. I was just calling to check um eligibility for a patient.
[AGENT][NEUTRAL] Right, I'm happy to check eligibility, [PII]. What's your policy number?
[CUSTOMER][NEUTRAL] I have 02094909 ML 8.
[AGENT][NEUTRAL] Thank you. And then for documentation, can I get a good callback number, please?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you. And then what's the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you. So patient is active. The effective date on here is [PII]. We are the members secondary insurance, so this does cover deductible, co-pay, co-insurance that the primary does not.
[AGENT][NEUTRAL] And do you need their outpatient benefits or?
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Uh yes, please. Outpatient benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So outpatient benefit max for the calendar year is 5500.
[AGENT][NEUTRAL] There is an outpatient deductible on here of 1000 it looks like.
[CUSTOMER][NEUTRAL] OK. So the patient still has to pay their deductible for the uh gap insurance?
[AGENT][NEUTRAL] For the secondary, yeah, I can see if they've had anything for the year. Let me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, so it looks like they haven't used it thus far this year. So the $1000 deductible would need to be met, of course, before anything was paid out on the $5500.
[CUSTOMER][NEUTRAL] All right. Cause the 5500 is for them to use um towards their primary insurance, whatever isn't covered, that would be used, correct?
[CUSTOMER][NEUTRAL] But once the $1000 deductible has been met.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Sorry, I, yeah, so, um, yeah, so basically you guys can bill us after the primary and then anything remaining would just if it qualifies it would just go towards our outpatient deductible of 1000 because they haven't met any of that for the year.
[CUSTOMER][POSITIVE] All right, perfect. Thank you so much, [PII]. And can I also please get your last name, initial and the reference number for the call?
[AGENT][NEUTRAL] Yeah, absolutely. Call reference is my name with today's date. My name is [PII] and that is spelled [PII].
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII].
[AGENT][POSITIVE] You have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.