AccountId: 011433970860
ContactId: 3423d908-91b0-4641-8120-ef1dfe708d36
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217889 ms
Total Talk Time (AGENT): 139358 ms
Total Talk Time (CUSTOMER): 55101 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/3423d908-91b0-4641-8120-ef1dfe708d36_20250210T14:48_UTC.wav
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[AGENT][NEUTRAL] Good Morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling from Homestead Hospital. I'm trying to verify benefits for a patient, please.
[AGENT][POSITIVE] All right, I'll be glad to help you and go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] Um, yes, my name is [PII]. Uh, member policy that I have, it's 594771049.
[AGENT][NEUTRAL] No that sounds like a social, so let me get over there, get that keyed in. OK, now while I'm excuse me, now while I'm doing that, please, [PII], go ahead and give me a good return telephone card number, please.
[CUSTOMER][NEUTRAL] [PII] option one.
[AGENT][POSITIVE] All right, [PII], thank you for that information. Let's see.
[AGENT][NEUTRAL] Uh, what's your patient's name?
[CUSTOMER][NEUTRAL] Uh, the patient is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] 285. OK, I think I see it. Let me get it pulled up. Let's see.
[AGENT][NEUTRAL] Alright, [PII], thank you for all that information. Uh let me go ahead and give you the correct policy number which you have is the social. So let me give you that correct policy number. This policy number needs to be on the claim when you send it in the APL. It is going to be 025.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 93413.
[CUSTOMER][POSITIVE] 13. All right, perfect. Is there a group number or no?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Uh, let me get over there. Let's see.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Um, yes, ma'am. Group number 24327.
[CUSTOMER][POSITIVE] 243-27. All right, perfect.
[AGENT][NEUTRAL] Yes, ma'am. OK, now I do show the original effective date on this medical supplemental plan is being [PII]. It is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want, uh, benefits. Is that correct?
[CUSTOMER][NEUTRAL] Yes, um, for outpatient hospital.
[AGENT][NEUTRAL] All right. Outpatient hospital. OK. Get over there, [PII]. Now what we are, [PII], is the medical supplemental plan, so the only thing.
[AGENT][NEGATIVE] That we will pick up and pay on it's for sickness and injury. Nothing routine here is covered at all.
[AGENT][NEUTRAL] And it has, excuse me, it has to be applied towards patients deductible copay or co-insurance to add her primary insurance carrier in order for us to review it. Now her outpatient benefit here is a zero deductible, no pre-cert, and a $1500 benefit per calendar date.
[CUSTOMER][NEUTRAL] Per calendar also per calendar day 1500.
[AGENT][NEUTRAL] Yes, ma'am, per calendar day. Is that all that I can help you with?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Um, that is all I need an authorization. You said you guys cover primary deductible copay and coinsurance. That's all they needed effective as of [PII].
[AGENT][POSITIVE] That is all correct information.
[CUSTOMER][POSITIVE] Alright, perfect, that's all I needed. I'm sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII], that is spelled [PII]
[CUSTOMER][NEUTRAL] Alright, can I just get a call reference number please?
[AGENT][NEUTRAL] We do not give call reference number, [PII], but you can use my name in today's date, and is that all that I can help you with?
[CUSTOMER][POSITIVE] That is it. Thank you so much for your help. I appreciate it. Have a wonderful day.
[AGENT][POSITIVE] Well, you as well, and thanks for calling APA [PII]. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.