AccountId: 011433970860
ContactId: 534e76e3-3c2e-4fdc-9c05-7464c5bacf57
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225509 ms
Total Talk Time (AGENT): 115184 ms
Total Talk Time (CUSTOMER): 94173 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/534e76e3-3c2e-4fdc-9c05-7464c5bacf57_20250319T18:11_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello. Good afternoon. My name is [PII]. I'm calling from Orlando Health Hospital. And I'm calling to verify benefits for a patient.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with those benefits this afternoon. What is a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is, excuse me, what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yes. Um, let's see.
[CUSTOMER][NEUTRAL] It's um 023.
[CUSTOMER][NEUTRAL] 406
[CUSTOMER][NEUTRAL] 48
[CUSTOMER][NEUTRAL] M for Mary, L for Lima, 8.
[AGENT][NEUTRAL] All right, thank you, [PII]. And what is the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] It's uh [PII] [PII].
[AGENT][POSITIVE] All right, thank you. I can help you with eligibility and benefits for [PII]. I'm showing that her policy is active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] And this is a secondary policy to her primary insurance. Are you needing specific benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yes. Will there be any, um, co-pay, deductible, co-insurance, or out of pocket? It was, um, for hospital inpatient ER admission.
[AGENT][NEUTRAL] All right, so with this policy, we're secondary, there's no deductible, co-pay, or co-insurance. We do pay toward the deductible co-pay or co-insurance of her major medical.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for inpatient, if she was in the hospital more than 18 hours, that is considered inpatient, and she has coverage up to $8700 per calendar year, and that is what we can pay toward her deductible, co-pay or co-insurance of her major medical.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you would please note that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, thank you. And um no out of pocket, right?
[AGENT][NEUTRAL] That's correct, not on this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so this will be a limited benefit plan, right?
[AGENT][NEUTRAL] It's a secondary gap policy.
[AGENT][NEUTRAL] To her major medical.
[CUSTOMER][NEUTRAL] OK. All right. Um, so, um, I guess, will this be, um, like I said, will this be a limited plan since it only covers like a certain amount of money per calendar year?
[AGENT][NEUTRAL] Yeah, it's your secondary gap policy. It's like a supplemental policy.
[CUSTOMER][NEUTRAL] OK. All right. OK, no problem. And will there be a, um, let's see. And the group number is uh 24757, right?
[AGENT][POSITIVE] Let me verify that for you. Yes, ma'am, that is correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, perfect. Thank you. And uh will there be a call reference number?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][POSITIVE] All right. OK, perfect. Mhm.
[AGENT][POSITIVE] And it was a pleasure to help you those citizens, [PII]. Anything else I can help you with today?
[CUSTOMER][POSITIVE] Uh, no, thank you. Have a great day.
[AGENT][POSITIVE] I hope you have a wonderful day as well, [PII]. Thank you for calling APL bye bye.
[CUSTOMER][NEUTRAL] Mm bye.