AccountId: 011433970860
ContactId: 4678c9ae-c203-4df0-bef8-deee8e063aa4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 403140 ms
Total Talk Time (AGENT): 140190 ms
Total Talk Time (CUSTOMER): 141187 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/4678c9ae-c203-4df0-bef8-deee8e063aa4_20250228T19:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I need to verify benefits and eligibility on a patient please.
[AGENT][NEUTRAL] Yes, Miss [PII], I can help you with benefits and eligibility. um can I please get your call back number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sure it's [PII]. That is my direct line.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEUTRAL] I'm calling from Jackson Purchase Medical Center in [PII].
[AGENT][NEUTRAL] OK, thank you. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It is [PII] and that's [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And I'm sorry, what was the other question?
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] Um, 02596268.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. This is a limited benefit hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK, so if the patient is here.
[AGENT][NEUTRAL] And the patient has, yes.
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] OK, I'm sorry you were cutting in and out. I, I apologize if you want to finish your sentence.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] No, that's OK. You go ahead and ask your question that way I can have.
[AGENT][NEUTRAL] Something to go on as far as what you need besides just general benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, she is here to actually.
[CUSTOMER][NEUTRAL] Have a screening mammogram. I do have CPT codes if you need them. I need to see if those are still covered. I'm not sure if we're in network with this insurance, but I didn't know, um, because it is limited, I think that means that only a certain amount would be paid towards the service.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Do we?
[AGENT][NEUTRAL] Right, um, so the patient does have office visits, and this is just to verify the benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] The stuff
[CUSTOMER][NEUTRAL] OK because
[AGENT][NEUTRAL] She has office visits she gets 4 a year.
[CUSTOMER][NEUTRAL] And we did
[AGENT][NEUTRAL] And it's $50.
[CUSTOMER][NEUTRAL] OK, now this is a hospital facility. It will be done in our facility, of course it is outpatient it's in our radiology department, so is that even covered?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, she has, uh,
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Let me pull her policy and see if ambulance is on this policy real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's gonna be just a second for the computer.
[CUSTOMER][NEUTRAL] No, that's fine thank you.
[AGENT][NEUTRAL] Or can load it and then I'm gonna have to dates.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEGATIVE] Uh, of course it's taking forever.
[CUSTOMER][NEUTRAL] It's the way it is and it's Friday.
[AGENT][POSITIVE] I know, always whenever I'm on the phone too like I can search policies and not be on a call and it'll pop right up.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What can I do for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] We do have him on for MRIs. We have him one for an MRI of the brain and one.
[CUSTOMER][NEUTRAL] them
[CUSTOMER][NEUTRAL] Yes, ma'am, bye bye.
[AGENT][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Would you like to work in scheduling?
[CUSTOMER][NEUTRAL] Oh yeah
[CUSTOMER][NEUTRAL] That's the one that told me
[AGENT][NEGATIVE] I'm gonna go a different direction real quick. This is just taking too long. Let me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That'd be fun I just bring them with you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] Yes, it is covered in a hospital outpatient facility.
[CUSTOMER][NEUTRAL] OK, can you tell me how much would be paid towards this since it's limited?
[AGENT][NEUTRAL] Right, let me look.
[CUSTOMER][NEUTRAL] to get
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] It would be $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and it does go through multi plan am I correct on that?
[AGENT][NEUTRAL] Yes ma'am and if you need to find out if you're in network I'll have to transfer you on over to them so that they can help you as far as um whether or not you're in network with them.
[CUSTOMER][NEUTRAL] We do accept multi plan so I do know that that's OK. I just needed to know, you know what what um.
[AGENT][POSITIVE] OK, good. OK.
[CUSTOMER][NEUTRAL] Network you went through on that one just to do a double check on it so I think you have answered all of my questions and did you say your name is [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK, and do you have a reference number for me?
[AGENT][NEUTRAL] Yes ma'am, you can use my name and today's date.
[CUSTOMER][POSITIVE] All right, thank you so much I hope you have a great afternoon and a great weekend.
[AGENT][POSITIVE] And you too, Miss [PII]. I hope you do too. It's Friday. Woo woo.
[CUSTOMER][POSITIVE] Thank you. Woohoo. Have a good one. Bye-bye.
[AGENT][POSITIVE] Yes you too thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] But.