AccountId: 011433970860
ContactId: 41481a7b-ca03-448d-bf2c-92308f1fb47e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 144899 ms
Total Talk Time (AGENT): 70619 ms
Total Talk Time (CUSTOMER): 39895 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/41481a7b-ca03-448d-bf2c-92308f1fb47e_20250529T19:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. This is [PII] with Memorial Healthcare Systems. I'm just calling to check eligibility and if authorization is needed for an exam.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Initial M [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] 02543182ML8
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][POSITIVE] Wow
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, for outpatient, we cover up to $1000 per day and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK. And is authorization required?
[AGENT][NEUTRAL] Um, no, there's no authorization required because this is secondary gap coverage and we go by the primary insurance guidelines. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] And what was your name again?
[AGENT][NEUTRAL] Uh my name is [PII]. Um it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Is there a call reference?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much for your time.
[AGENT][POSITIVE] Uh, thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mm