AccountId: 011433970860
ContactId: 25acb9e7-b5f9-4388-8714-a7d4509c0a2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160779 ms
Total Talk Time (AGENT): 60675 ms
Total Talk Time (CUSTOMER): 76149 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/25acb9e7-b5f9-4388-8714-a7d4509c0a2e_20250127T19:14_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling for Nicholas Children's Hospital to verify benefits and eligibility.
[AGENT][POSITIVE] Sure, [PII], I can assist you with it.
[AGENT][NEUTRAL] I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. It's uh callback number is.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the policy number is
[CUSTOMER][NEUTRAL] 02443491 M as in Mike L as in Lima 8.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Thank you, [PII]. What is the policy, the member's name that you're inquiring eligibility for today?
[CUSTOMER][NEUTRAL] The first name is [PII] and last name is [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for what place of service?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] It's for hospital outpatient uh diagnostic X-ray.
[CUSTOMER][NEUTRAL] What are you going?
[AGENT][NEUTRAL] This member's policy has been active since [PII] and it's currently active.
[AGENT][NEUTRAL] And [PII] has outpatient benefits of $6000 per calendar year, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and what is the net amount?
[AGENT][NEUTRAL] She has not utilized any of her benefits for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, do you have a primary insurance details for this patient?
[AGENT][NEUTRAL] And we're not affiliated with it. We're just a gap insurance to the primary. So you may wanna reach out to the individual to verify what's their primary insurance.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, thank you so much. Let me reconfirm the information you have provided. The plan is active from [PII] and the lifetime maximum amount is $6000 and nothing has been met yet, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK. Can you please spell your name with initial?
[AGENT][NEUTRAL] [PII]. First initial and my last name is [PII], and you can use my name and today's date of reference, [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yeah, thank you so much for your information. Have a great day. Bye. Yeah, bye.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well. Goodbye.