AccountId: 011433970860
ContactId: 553fa52f-c721-40bd-b59c-c11f012410ef
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199940 ms
Total Talk Time (AGENT): 83403 ms
Total Talk Time (CUSTOMER): 61388 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/553fa52f-c721-40bd-b59c-c11f012410ef_20250203T21:42_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. Um, my name is [PII]. I'm calling from uh Baptist Hospital Miami. Uh, I just wanna check to see if this patient is currently active and if there's any accumulations towards their, um, out of pocket max or their max a year.
[AGENT][NEUTRAL] OK, well, I can definitely assist you with the eligibility and their usage, um, their benefit usage. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh yes, it's [PII]. And my contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02260535 ML 8.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, yes, it's [PII], [PII].
[AGENT][NEUTRAL] Alright, and thank you so much for verifying the member's information and all the information provided is a verification of benefits, not a guarantee of payment. So this particular policy is no longer active. It was effective from [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] There is an active policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][POSITIVE] OK, OK, I'm ready.
[AGENT][NEUTRAL] Alright, so it's 2456411.
[CUSTOMER][NEUTRAL] OK, and it's through American uh APL or?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, it's still, it's still with us. They just have a, it's just that the other policy lapsed. Um, this, this policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. Got it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it's still active.
[CUSTOMER][NEUTRAL] OK. And what's your yearly max?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] And it's for outpatient hospital setting.
[AGENT][NEUTRAL] So for outpatients, the policy will pay up to $3500 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let me see if they've used any for this year.
[AGENT][NEGATIVE] And for this year, um, none of the benefits have been used.
[CUSTOMER][NEUTRAL] OK. And just to confirm, the member ID number is 2456411?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, perfect. I'm sorry, can I get your name one more time?
[AGENT][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII]. Have a wonderful day.
[AGENT][POSITIVE] You also, [PII], thanks for calling APL. Have a great day.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] You too. Thanks. Bye bye.