AccountId: 011433970860
ContactId: 48e95c50-b14b-48bb-9a40-a8f029c97f01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196429 ms
Total Talk Time (AGENT): 103488 ms
Total Talk Time (CUSTOMER): 64381 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/48e95c50-b14b-48bb-9a40-a8f029c97f01_20250317T20:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes hello my name is [PII], um, I'm with Community Hospital. I'm actually just wanting to verify eligibility and benefits and see if an authorization is required.
[AGENT][NEUTRAL] OK Miss [PII], I can help you with eligibility and um authorization. Can I please get your call back number ma'am just in case our call is disconnected.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, it's [PII]. Date of birth is [PII]. The policy number I have is 02550928.
[AGENT][NEUTRAL] OK, let me repeat the policy 02509258.
[CUSTOMER][NEUTRAL] Um, what it says 025 and then 50928, so there's there's 2 5s.
[AGENT][NEUTRAL] 0 2550928. OK, got it. Let me pull it up real quick.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK I do show that [PII] does have an active policy. His effective date is.
[AGENT][NEUTRAL] [PII] and there's no pre-authorization required because this is not the major medical, this is a secondary gap insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and what, what, since it is a secondary gap insurance, is there like a deductible or out of pocket, or is it just covered at 100%?
[AGENT][NEUTRAL] Um, let me, um, look real quick.
[AGENT][NEUTRAL] OK, and this is just to verify benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So this policy helps with deductible, co-pay, and co-insurance. The insured has an inpatient calendar year benefit amount of $5000 and he has an outpatient benefit amount per calendar year also of $5000 to go towards deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK, and does does it show if he's met any of that or does.
[CUSTOMER][NEUTRAL] Is there any accumulations? I can't talk. I'm sorry.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] That's OK. That's OK. Let me look real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Nothing has been used for the year of [PII].
[CUSTOMER][NEUTRAL] OK, um, and do you have a call reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] Um, no, that, that was it. You, you answered all my questions.
[AGENT][POSITIVE] All right, well, you have a wonderful day and thank you for calling APL.
[CUSTOMER][NEUTRAL] So I, I
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] Mm bye bye.
[CUSTOMER][NEUTRAL] OK.