AccountId: 011433970860
ContactId: 548ebc9a-b0a3-4e1f-84e8-91b7664bc6fa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185210 ms
Total Talk Time (AGENT): 81683 ms
Total Talk Time (CUSTOMER): 95490 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/548ebc9a-b0a3-4e1f-84e8-91b7664bc6fa_20250529T18:22_UTC.wav
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[AGENT][POSITIVE] Thank you for calling this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII]. I'm calling from Memorial Regional Hospital, and I was hoping um to obtain benefits and eligibility for a mutual member, please.
[AGENT][NEUTRAL] I can check eligibility and benefits for you, uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] I do policy number it is.
[CUSTOMER][NEUTRAL] Uh, inpatient cert, hold on, uh oh, I have a group number, a benefit cert number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we can try that.
[CUSTOMER][NEUTRAL] Is that it? Hold on, let me go back.
[CUSTOMER][NEUTRAL] Hold on let me see.
[CUSTOMER][NEUTRAL] I'm just trying to see where it is on this card.
[AGENT][NEUTRAL] Um, we could try that certification number. Oh yeah, go ahead.
[CUSTOMER][NEUTRAL] 0 02.
[CUSTOMER][NEUTRAL] OK, 02552438 and then I've got M as in Mike, L as in Lima, and then the number 7.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yes, his name is [PII], [PII] is what I have.
[AGENT][NEUTRAL] Perfect, thank you for verifying that. OK, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at inpatient or outpatient benefits for this member.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, if we can look at the inpatient benefits please.
[AGENT][NEUTRAL] Inpatient for sure and of course I will let you know verification of coverage is not a guarantee of payment for claims so that inpatient benefit is $3000 max per confinement.
[CUSTOMER][NEUTRAL] $3000 max per confinement.
[AGENT][NEUTRAL] Correct, that's the benefit amount that we would pay.
[CUSTOMER][NEUTRAL] Can
[CUSTOMER][NEUTRAL] OK, so that's like the the max you would pay.
[AGENT][POSITIVE] Correct, per confinement.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Max perfect and OK awesome. I think that was all I needed that's that's there's no other like co-pays, deductibles, or anything else that may apply. It's just that.
[AGENT][NEGATIVE] Right, no, not for this plan.
[CUSTOMER][NEUTRAL] OK, perfect. And you, you mentioned it's a medical secondary policy, is that right?
[AGENT][NEUTRAL] That's correct. So, uh, for claims we would need the uh primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you and um how do you spell your first name? I'm sorry?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's OK, it's [PII]. And was there anything else I could help you with?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Um, no, I'll just, uh, if you give out a reference number I'll take that and that's it.
[AGENT][NEUTRAL] Oh sure, that would just be my first name, last initial and today's date, uh, so my last initial is A.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Awesome thank you so much I appreciate it have a great day.
[AGENT][POSITIVE] Yes ma'am, of course, thanks for calling APL have a great rest of your day thank you bye bye.
[CUSTOMER][NEUTRAL] You too bye bye.