AccountId: 011433970860
ContactId: 358609b3-ad61-4add-85bd-9b5966267621
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171710 ms
Total Talk Time (AGENT): 79800 ms
Total Talk Time (CUSTOMER): 54895 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/358609b3-ad61-4add-85bd-9b5966267621_20250528T21:06_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Nicholas Children's Hospital for Benefits. What did you say your name is?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, my name is [PII], and yours?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 01066938.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, I'm showing his effective date is [PII]. He is active on the policy and what benefits are you needing for this patient?
[CUSTOMER][NEUTRAL] Outpatient?
[AGENT][NEUTRAL] OK, give me a moment.
[CUSTOMER][NEUTRAL] Hospital.
[AGENT][NEUTRAL] OK. Um, not a guarantee of payment, just a verification of coverage. With this policy, we are secondary. We help with primary insurance deductible, co-pay and or co-insurance. And for outpatient, uh, he has a benefit max of up to $500 per occurrence.
[CUSTOMER][NEUTRAL] Up to how much a year?
[AGENT][NEUTRAL] Uh, it's not a yearly max, it's a current.
[CUSTOMER][NEUTRAL] Oh, a daily max. OK.
[AGENT][NEUTRAL] No, ma'am, not daily occurrence. Um, like if it's the same or related condition has to be separated by 90 days before we can pay up that benefit again.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] So it's not a daily.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me write that down.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right, let me have uh the uh call reference number, please.
[AGENT][NEUTRAL] Uh, if you like, you may use my name at today's day, uh, today, lower words, you may use my name at today's date.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] [PII] is it [PII]?
[AGENT][NEUTRAL] Uh [PII]
[CUSTOMER][NEUTRAL] What is the last initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Got it. I understood too. I'm like, no, that's, I, I didn't understand that right. Thank you so much, [PII]. Have a beautiful day.
[AGENT][NEUTRAL] Yes, we are.
[AGENT][POSITIVE] All right, you're welcome and thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Bye, you too.