AccountId: 011433970860
ContactId: 25d2a504-d837-4402-98b8-f5a966810072
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171369 ms
Total Talk Time (AGENT): 83399 ms
Total Talk Time (CUSTOMER): 54161 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/25d2a504-d837-4402-98b8-f5a966810072_20250314T17:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'm calling from Bakti Hospital. I need to check eligibility on benefit for an operation for um a patient please.
[AGENT][POSITIVE] All right. I'm happy to check eligibility and benefits today. What's the patient's policy number?
[CUSTOMER][NEUTRAL] I actually I have two policies. I'm not sure which one is the one active. I'm gonna give you the first one is 01813046 ML 8.
[AGENT][NEUTRAL] OK, let me pull this up, [PII], one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Right, that doesn't have that member's name on it. What's the other number you have?
[CUSTOMER][NEUTRAL] I have 2549483.
[AGENT][NEUTRAL] And then I apologize. I mean, what was the date of birth again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right. So that's gonna be your patient's plan. Um, it is active. The effective date is [PII].
[AGENT][NEUTRAL] And we're the members secondary insurance, so this is gonna cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] OK, sure. There's any amount uh for the year?
[AGENT][NEUTRAL] Let me check and see what the outpatient amount is let's see.
[AGENT][NEUTRAL] Uh, looks like the outpatient max under the patient plan for all persons is 18,000.
[CUSTOMER][NEUTRAL] The individual or the family?
[AGENT][NEUTRAL] For the family.
[CUSTOMER][NEUTRAL] Individual?
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Um, let's see, it's 6000.
[CUSTOMER][NEUTRAL] Does she um does she have to use any of these or?
[AGENT][NEUTRAL] Um, let me check and see if anything's been used thus far. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like the amount paid to date is $220.20.
[CUSTOMER][NEUTRAL] OK, OK. Can I have a reference number for this call, please?
[AGENT][NEUTRAL] Call reference is going to be my name with my last initial then today's date. My name again is [PII], that's [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you again. Thank you. Have a good day.
[AGENT][POSITIVE] You're welcome. You too. Bye bye.
[CUSTOMER][POSITIVE] Thank you bye bye.