AccountId: 011433970860
ContactId: 305f5c0c-6362-4efa-b1f2-637615d07561
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224839 ms
Total Talk Time (AGENT): 91860 ms
Total Talk Time (CUSTOMER): 51369 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/305f5c0c-6362-4efa-b1f2-637615d07561_20250604T15:07_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hey, good morning, [PII] how are you doing today?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][POSITIVE] Not too bad. I'm calling to go ahead and check eligibility and get benefits on the patient's uh coverage.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, that's [PII] and then the phone number is gonna be [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh yes, I have a 02583990.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh yeah [PII], [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. So I, um, I am showing that the policy is active. It's been effective since [PII]. And what type of um benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Uh, surgery for, uh, inpatient surgery at a hospital facility.
[AGENT][NEUTRAL] OK, so for inpatient, the policy would pay up to $500 per person per calendar year.
[CUSTOMER][NEUTRAL] OK, uh, and is that, is that full amount available as of yet or has that already been used?
[AGENT][NEUTRAL] Let me see, hold on one second.
[AGENT][NEUTRAL] Wait a minute, hold on one moment. Do you mind if I place you on just a brief hold? I'm just looking at the benefits.
[CUSTOMER][POSITIVE] Yeah sure take your time.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, what now? Individual max is $500. 0, cause that's a wait, but outpatient.
[AGENT][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Per day for outpatient.
[AGENT][NEUTRAL] Oh, cause it's per day and that's outpatient, we're looking at inpatient.
[AGENT][NEUTRAL] So let me make sure.
[AGENT][NEUTRAL] Yeah, this is all outpatient so she hasn't used any of the inpatient benefits yet.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. So no, she has not used any of the inpatient benefits for this year.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And are you able to provide me with a reference number for the call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] Alright, thank you very much for that confirmation of benefits. I appreciate it.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, no, that was it.
[AGENT][POSITIVE] Alright, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.