AccountId: 011433970860
ContactId: 4a782aa8-7b85-49d8-9e52-7b23a84c3f49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231020 ms
Total Talk Time (AGENT): 111840 ms
Total Talk Time (CUSTOMER): 56394 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/4a782aa8-7b85-49d8-9e52-7b23a84c3f49_20250212T21:27_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Nicholas Children's Hospital to know about an authorization number for the patient who have an appointment.
[CUSTOMER][NEUTRAL] Uh, sorry, the, uh, to check out and, uh,
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Benefits are eligibility of the patient.
[AGENT][NEUTRAL] OK, [PII], um, and what was the name of the facility you're calling from again, sir?
[CUSTOMER][NEUTRAL] Yeah, it's uh Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK [PII], what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name?
[CUSTOMER][NEUTRAL] Patient name [PII] and Stay.
[AGENT][NEUTRAL] OK. And what's the patient's date of birth?
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] And the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, so 1353178 M for Mary, L for Lima 8.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, I do see that [PII] does have an active policy. The effective date is [PII]. No pre-authorization is needed because this is not the primary insurance.
[AGENT][NEUTRAL] Uh, this is just to verify coverage is not a guarantee of payment. This is a secondary gap insurance that helps with deductible, co-pay, or co-insurance.
[AGENT][NEUTRAL] The patient has, uh, inpatient benefit amount.
[AGENT][NEUTRAL] Of $2000 per calendar year and the patient also has an outpatient benefit amount of $2000 per calendar year.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, may I know the effective and termination date?
[AGENT][NEUTRAL] The effective date of the policy is
[AGENT][NEUTRAL] [PII] and there is no termination date. The policy is active.
[CUSTOMER][NEUTRAL] As a secondary covered 100%, right?
[AGENT][NEUTRAL] I'm sorry, what did you just say, sir?
[CUSTOMER][POSITIVE] Yeah, active as a secondary and it's covered 100%, right?
[AGENT][NEUTRAL] Well, the effective date is [PII] and the policy is active to current, yes.
[CUSTOMER][NEUTRAL] OK, and the coverage is 100%, right?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, that's not what I said.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is a gap insurance that helps with deductible, co-pay, or co-insurance. This is just to verify coverage. It's not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] They have a calendar year benefit amount of $2000 for inpatient and outpatient.
[CUSTOMER][POSITIVE] OK, sure, thank you so much. Can I have a reference number?
[AGENT][NEUTRAL] Yes, you can use my name's [PII], and today's date.
[CUSTOMER][NEUTRAL] Sorry, could you spell your name?
[AGENT][NEUTRAL] Yes, sir. It's [PII]
[CUSTOMER][POSITIVE] Thank you [PII]. Have a good day bye for now.
[AGENT][POSITIVE] You too. Thank