AccountId: 011433970860
ContactId: 3b3cd5b2-3835-449d-bcc7-bf7922549f07
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249940 ms
Total Talk Time (AGENT): 129309 ms
Total Talk Time (CUSTOMER): 76358 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/3b3cd5b2-3835-449d-bcc7-bf7922549f07_20250404T17:45_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Hi, good afternoon, we're calling you from Palmetto General Hospital in regards to a patient that was admitted here. He, the family member, provided the, the gap insurance, and we just need to verify the benefits and eligibility.
[AGENT][NEUTRAL] OK, so you need to verify eligibility and benefits for a member, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes sir, I can help you with that and who am I speaking with please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII]. My [PII] is [PII]. I'm sorry, what was your name again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII] Toyy, OK, and what would be the last name initial?
[AGENT][NEUTRAL] [PII]. And your last name initial, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the patient's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Sure, as per family member, policy number is 02260524 M as in mom, L as in Larry 7.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] O
[AGENT][NEUTRAL] OK, and [PII], any information I do provide will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, first name [PII] last name [PII]. Patient was born [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. So I do show that he is a subscriber on the supplemental policy, and the supplemental policy is, excuse me, this supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you were needing inpatient benefits, is that correct?
[CUSTOMER][POSITIVE] Yes, impatient.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the inpatient benefit maximum on the supplemental policy is $6350 per calendar year.
[AGENT][NEUTRAL] And there is no inpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, again you said 6550.
[AGENT][NEUTRAL] No, 6350.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, 350, OK.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Yes sir now because it is a supplement to his primary insurance, [PII], when the claim is submitted to us for review, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check our claim status and our portal website is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, is there anything else, [PII], that I can help you with today?
[CUSTOMER][POSITIVE] Perfect, OK.
[CUSTOMER][POSITIVE] No, no, that will be all thank you so much for your help, OK?
[AGENT][POSITIVE] Well, you're very welcome and thank you for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.