AccountId: 011433970860
ContactId: 1e06e787-23dc-4b90-bc04-4a6b4be088e9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196210 ms
Total Talk Time (AGENT): 87841 ms
Total Talk Time (CUSTOMER): 51452 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/1e06e787-23dc-4b90-bc04-4a6b4be088e9_20250114T21:08_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][POSITIVE] Yes ma'am, good afternoon. I need to gather uh eligibility and benefits for a patient. I'm so sorry, what was your first name?
[AGENT][NEUTRAL] Oh yes, it's [PII]
[CUSTOMER][POSITIVE] OK perfect thank you uh.
[AGENT][NEUTRAL] And you said you're looking for eligibility and benefits and I'm so sorry uh can I have your first name again as well?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][POSITIVE] [PII], thank you so much and then do you mind if I'll just snag a quick call back number from you?
[CUSTOMER][NEUTRAL] Yes ma'am, that's gonna be [PII] so it's [PII].
[AGENT][POSITIVE] Thank you and let me see.
[AGENT][NEUTRAL] Your member's policy number please?
[CUSTOMER][NEUTRAL] Yes, hold on just a moment.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] That's gonna be 1869088.
[AGENT][POSITIVE] Perfect and give me a moment to get that all pulled up for you my friend.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, thank you. um, can I have your patient's first and last name and date of birth please?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII], and date of birth is [PII].
[AGENT][POSITIVE] [PII] perfect and.
[AGENT][NEUTRAL] As far as the eligibility goes, your patient is current and active. She's been effective with us since [PII].
[AGENT][NEUTRAL] And then as far as eligibility goes, was there any other information you're needing?
[CUSTOMER][NEUTRAL] Yes, um, is there a deductible co-payment?
[AGENT][NEUTRAL] OK, yeah, absolutely, um, any benefit information I give you over the phone, I do wanna let you know it's just a verification of coverage and not a guarantee of payment. Um, she does not have any deductibles or co-payment with us. Um, are you looking for outpatient or inpatient benefits today, my friend?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And patient.
[AGENT][NEUTRAL] Inpatient, you bet you, um, she does have an inpatient calendar year maximum of $2550.
[CUSTOMER][NEUTRAL] And that would be uh I'm sorry, what again?
[AGENT][NEUTRAL] Um, her inpatient calendar year maximum.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, we're her gap insurance, so we're gonna work to pick up on anything her major medical leave to her copay, co-insurance, or deductible.
[CUSTOMER][NEUTRAL] OK, um, so this patient does not have a deductible or co-payment with this particular plan, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, uh, do you have a reference number for the call?
[AGENT][NEUTRAL] Oh yeah, you betcha. Um the reference number is my name [PII] in today's date.
[CUSTOMER][POSITIVE] OK perfect thank you you as well.