AccountId: 011433970860
ContactId: 58e722be-0564-4301-bf89-937810eb1663
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 159720 ms
Total Talk Time (AGENT): 73440 ms
Total Talk Time (CUSTOMER): 45889 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/58e722be-0564-4301-bf89-937810eb1663_20250502T16:50_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Nicholas Children's Hospital authorization department. I'm calling to get an effective date and outpatient services, uh, eligibility.
[AGENT][NEUTRAL] OK, I can verify eligibility for you, Ms. [PII], and what is that policy number, please?
[CUSTOMER][NEUTRAL] The policy number is 02260491M as in Mary, L as in Larry the number 8.
[AGENT][POSITIVE] OK, thank you so much, give me one moment please.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII] [PII].
[AGENT][NEUTRAL] OK, and you say you're calling to verify eligibility, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I show his effective date is [PII] and he is active under the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when you're ready I just need the outpatient services.
[AGENT][NEUTRAL] Oh you needing benefits, OK, uh, let's see for outreach.
[CUSTOMER][NEUTRAL] Right, I need to know uh what the coverage is for outpatient services.
[AGENT][NEUTRAL] OK, and let's see, uh, not a guarantee of payment, just a verification of coverage. With this policy, we are secondary. We help with major medicals, deductibles, co-pay, and or co-insurance, and the patient has a benefit max of up to $6350 per calendar year.
[CUSTOMER][NEUTRAL] Anything available?
[AGENT][NEUTRAL] Uh, give me a moment.
[AGENT][NEUTRAL] Uh, it looks like he hasn't used any of his benefits for this year, so it is available.
[CUSTOMER][NEUTRAL] OK great can I have a reference number?
[AGENT][NEUTRAL] Uh, you may use my name in today's date if you like.
[CUSTOMER][NEUTRAL] How do you spell your name?
[AGENT][NEUTRAL] I'm so sorry. It's [PII].
[AGENT][NEUTRAL] And is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, nothing else. Thank you so much.
[AGENT][POSITIVE] Alright, you're welcome.