AccountId: 011433970860
ContactId: 3fe2f0de-eb55-4816-ba50-9becfa12f0ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169880 ms
Total Talk Time (AGENT): 85333 ms
Total Talk Time (CUSTOMER): 70526 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/3fe2f0de-eb55-4816-ba50-9becfa12f0ce_20250128T23:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you? My name is [PII]. I'm calling from South Miami Hospital. I'm calling to verify benefits please.
[AGENT][POSITIVE] Yeah, I could take benefits for you. I'm sorry, you said your name was [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], sorry about that. OK, um, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yes. It's
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. My question to you is what would, which one would it be if they're in an emergency room because this is in-hospital benefits or outpatient benefits.
[AGENT][POSITIVE] Oh, you can give me either of them and I'll be able to get the policy pulled up. That's perfectly fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it's 02388734, M as in Mary, L as in Larry, and 7.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and then uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] OK. The name is [PII] Last name is [PII] I believe that's I.
[CUSTOMER][NEUTRAL] Um, and the date of birth is [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and you said this was for an emergency room visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was outpatient correct?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, bear with me just a moment.
[AGENT][NEUTRAL] Alright, so that would fall under their outpatient benefit. Um, outpatient benefits is on a per calendar day basis, so that is $3000 max per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, perfect. OK, I'm sorry, what was your name again?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's OK, it's [PII]
[CUSTOMER][NEUTRAL] OK. And do you have a reference number for me?
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII], last initial is A.
[CUSTOMER][NEUTRAL] What's your last initial?
[CUSTOMER][POSITIVE] OK, got it perfect.
[AGENT][NEUTRAL] Was there anything else I can help you with tonight?
[CUSTOMER][POSITIVE] That's it. Thank you so much.
[AGENT][POSITIVE] OK, yeah, thanks for calling [PII]. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Have a great day. All right. You too. Bye.
[AGENT][POSITIVE] Thank you bye bye.