AccountId: 011433970860
ContactId: 5342d3e7-778f-46af-81ba-801a4180b32a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 156440 ms
Total Talk Time (AGENT): 70850 ms
Total Talk Time (CUSTOMER): 55622 ms
Interruptions: 0
Overall Sentiment: AGENT=2.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/5342d3e7-778f-46af-81ba-801a4180b32a_20250513T20:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from South Miami Hospital. Um, I had a patient come into the ER and they have the APL as GAP, and I just wanted to uh verify the benefits and see, make sure it's active.
[AGENT][POSITIVE] OK, certainly I can help you with that [PII]. What is your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you so much. And may I have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02432942.
[CUSTOMER][NEUTRAL] And then ML 8.
[AGENT][POSITIVE] OK, thank you so much. One moment.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, it's [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you very much for [PII], and you're calling to verify eligibility and you need benefits for ER is that correct? Both.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, certainly I can help you with that. Um, she is the policy holder with an effective date of [PII]. Policy shows active for the member and for benefits. Please note verification of benefits provided does not guarantee payment. We pay up to $5000 for the calendar year.
[CUSTOMER][NEUTRAL] OK, that's.
[AGENT][NEUTRAL] And I can check to see if anything has been accumulated towards that if you like.
[CUSTOMER][NEUTRAL] Oh, yes, please.
[AGENT][NEUTRAL] OK, of course, one moment.
[AGENT][NEUTRAL] Currently it shows that she has accumulated.
[AGENT][NEUTRAL] The max of 5000.
[CUSTOMER][NEUTRAL] Oh, she's a max of 5000, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So then, um, OK, so if she has an ER co-pay with her insurance, she will be responsible with that cause she's already met her max.
[AGENT][NEUTRAL] She's met her Max with us. I'm not sure if she has another insurance, but she has met her cus excuse me, her calendar year Max with us.
[CUSTOMER][POSITIVE] OK, OK, perfect, thank you so much for that.
[AGENT][POSITIVE] You're welcome. You're welcome. Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Um, no, that'll be everything.
[AGENT][NEUTRAL] OK, we do not use reference numbers. You can use my name [PII] last initial [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for your help, [PII].
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Take care bye.