AccountId: 011433970860
ContactId: 141f5ca0-d37a-4666-a781-73a251779bbb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 152300 ms
Total Talk Time (AGENT): 68682 ms
Total Talk Time (CUSTOMER): 69915 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/141f5ca0-d37a-4666-a781-73a251779bbb_20250418T14:10_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. Good morning. My name is [PII]. I'm calling because I want to verify the eligibility and benefits for one patient. I'm calling from MCI Baptist Hospital.
[AGENT][POSITIVE] I'm sure, [PII] I can assist you with benefits. And first, I'll need to go callback number just in case we're disconnected.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, I have 02493378.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Name [PII], last name [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's an outpatient outpatient facility.
[AGENT][NEUTRAL] OK, for outpatient, we cover up to 500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, so that is the the maximum is 500, correct?
[AGENT][NEUTRAL] Yes, ma'am, per calendar year.
[CUSTOMER][NEUTRAL] For calendar year, yeah, per year. And it's something new or?
[AGENT][NEUTRAL] Um, no, the full 500 is available. She hasn't used any this year.
[CUSTOMER][POSITIVE] It's available. OK. Alrighty. OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So, that's fine. So it's 500. OK. And can I, I think that will be all. This is a gap insurance, correct?
[AGENT][NEUTRAL] Yes, ma'am. It's Gap Insurance. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, that would be all. Can I have like a reference number for this call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII], um it's spelled [PII] Last initial [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you, [PII]. Thank you very much and have a great day.
[AGENT][NEUTRAL] You do the same, um, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you bye bye.