AccountId: 011433970860
ContactId: 27f63ca1-19b9-4ff1-80e1-010d6405197d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 150669 ms
Total Talk Time (AGENT): 83269 ms
Total Talk Time (CUSTOMER): 61031 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/27f63ca1-19b9-4ff1-80e1-010d6405197d_20250212T22:26_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so my name is [PII]. I'm calling to check the eligibility and benefits of a patient that we have here with the gap insurance.
[AGENT][NEUTRAL] OK, sure, I can assist you with eligibility and benefits, and I'm sorry, you said your name is [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, I'm gonna start it and uh.
[AGENT][NEUTRAL] OK, thank you. That's fine. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and you say you're calling from which facility or provider?
[CUSTOMER][NEUTRAL] Yes, providers from Nicholas Children's Outpatient center.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] That's 02556519.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK, what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], date of birth, just give me one moment. [PII].
[AGENT][NEUTRAL] All right, perfect. Thank you, [PII]. All right, and we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical and we have an outpatient maximum of 8700 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mo
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] 8700, has that been met at all?
[AGENT][NEUTRAL] It started all over again this year. I can check and see if he has to use any of his benefit. Let's see.
[CUSTOMER][NEUTRAL] OK, yes, because um this patient is going to get an X-ray done, so I just need to make sure that he's able to do it without an authorization.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh yes, uh, with us, there's no authorization needed because we're just the secondary supplemental plan um.
[AGENT][NEUTRAL] And they have not used their benefits for [PII] as of today, so they still have the full amount available.
[CUSTOMER][POSITIVE] OK perfect thank you so much and is there a reference number for this call?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] if you will
[CUSTOMER][NEUTRAL] Your name is [PII]?
[AGENT][NEUTRAL] Yes, last initial [PII]
[CUSTOMER][POSITIVE] OK perfect thank you so much I really appreciate your help.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, Ms. [PII].
[CUSTOMER][POSITIVE] Thank you, you too.