AccountId: 011433970860
ContactId: 1eb9adbe-6546-442f-b6ea-8e1aed3fd16b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210360 ms
Total Talk Time (AGENT): 107113 ms
Total Talk Time (CUSTOMER): 57037 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=3.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/1eb9adbe-6546-442f-b6ea-8e1aed3fd16b_20250110T15:09_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][POSITIVE] Good morning how are you?
[AGENT][POSITIVE] I'm doing well this morning. How are you doing?
[CUSTOMER][POSITIVE] I'm good, can't complain.
[AGENT][POSITIVE] Awesome
[CUSTOMER][POSITIVE] Thank you for asking.
[AGENT][POSITIVE] Yes ma'am, thank you for asking me. It's almost weekend time.
[CUSTOMER][POSITIVE] Thank God, thank [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I'm calling to get benefits and eligibility for a member please.
[AGENT][NEUTRAL] OK, I can help you with the benefits and the eligibility. Can you please give me your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Of course it's [PII].
[CUSTOMER][NEUTRAL] And it's [PII].
[CUSTOMER][NEUTRAL] [PII] and my direct extension is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. What is the patient's name, please?
[CUSTOMER][NEUTRAL] The patient's name is [PII].
[AGENT][NEUTRAL] OK. And then what is the patient's date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And the patient's policy number, please.
[CUSTOMER][NEUTRAL] Of course it's 146.
[CUSTOMER][NEUTRAL] 3373 ML 8.
[AGENT][NEUTRAL] OK, let me get that pulled in for us real quick.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're very welcome.
[AGENT][POSITIVE] OK, I do show that [PII] does have an active policy.
[AGENT][NEUTRAL] Her effective date is
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And this is just to verify coverage. It's not a guarantee of payment. She has a supplemental insurance policy that is secondary to her primary. The policy helps with deductible, co-pay and co-insurance. She has an inpatient calendar year benefit amount of $6500 and then she also has an outpatient calendar year benefit amount of $6000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we repeat that again because I'm a little confused. I'm sorry.
[AGENT][NEUTRAL] OK, so it helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she has an inpatient benefit amount of $6500.
[AGENT][NEUTRAL] And then she also has an outpatient benefit amount of $6000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and out of the 6500 how much has she met?
[AGENT][NEUTRAL] Let me look and see if she's used anything so far this year.
[CUSTOMER][POSITIVE] OK thank you OK thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] She hasn't used anything thus far this year.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect. OK, [PII], can I just have a reference for the call please?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much you have a good weekend OK?
[AGENT][POSITIVE] You too you have a blessed one thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye, Ms. [PII].
[CUSTOMER][POSITIVE] Thank you.