AccountId: 011433970860
ContactId: 141a8a61-ddae-44f3-858b-fe7a0bf35b84
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176820 ms
Total Talk Time (AGENT): 63741 ms
Total Talk Time (CUSTOMER): 77878 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/141a8a61-ddae-44f3-858b-fe7a0bf35b84_20250505T13:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII]. I'm calling from.
[CUSTOMER][NEUTRAL] Um, Mariners' Hospital in [PII], and I needed to get coverage, um, and eligibility on a patient.
[AGENT][POSITIVE] OK, I can help you with benefits and eligibility, [PII]. Do you have a good callback number, please?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] The policy number of the patient.
[CUSTOMER][NEUTRAL] The policy number is.
[CUSTOMER][NEUTRAL] 02480051 ML 7.
[AGENT][NEUTRAL] OK, thank you. And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Just for outpatient benefits.
[CUSTOMER][NEUTRAL] Yes, it is. She was here in the ER. [PII], what is the uh your initial of your last name?
[AGENT][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, get that pulled up, and give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I show the policy is effective [PII]. It's currently active.
[AGENT][NEUTRAL] And this is not a guarantee of payment, basic outline of the policy.
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or outpatient benefits, let's see.
[AGENT][NEUTRAL] And so she has a $750 per covered person per calendar day maximum benefit payable. That's after primary processes the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, the 7:15 means that she has.
[AGENT][NEUTRAL] So this is a secondary gap policy. So basically, once primary processes the claim, that 750 will pay towards any leftover, deductible or co-insurance that the primary didn't pick up.
[CUSTOMER][NEUTRAL] Pays deductible. Does it also pay copays?
[AGENT][NEUTRAL] Yes, so any, yes.
[CUSTOMER][NEUTRAL] Because she has $1000 she has a $1000 co-payment for the ER.
[AGENT][NEUTRAL] Yes, it would, it would pick up up to 7:50, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Do we have a call a reference number for this call?
[AGENT][NEUTRAL] Uh, it's just my name and today's date. And is there anything else I can help with today?
[CUSTOMER][POSITIVE] No, that's it you've been wonderful thank you so much, OK, and have a great day.
[AGENT][POSITIVE] Thank you for calling APLU as well. Bye-bye.
[CUSTOMER][NEUTRAL] All right bye bye.