AccountId: 011433970860
ContactId: 5e6868e5-0410-4e0e-a9ed-fe00325e852a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163440 ms
Total Talk Time (AGENT): 80978 ms
Total Talk Time (CUSTOMER): 67133 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/5e6868e5-0410-4e0e-a9ed-fe00325e852a_20250527T22:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I need to get uh benefits and eligibility for a member and also to find out if authorizations required.
[AGENT][NEUTRAL] OK, yeah, I can check eligibility and benefits and then see if authorization is required um what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Sure, my name is [PII]. It's [PII] last [PII] [PII].
[AGENT][NEUTRAL] OK, and then [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] That is um [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] I do. That is going to be.
[CUSTOMER][NEUTRAL] 01869495.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Um, her name is [PII] Her. Date of birth [PII].
[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 as it is very dependent on major medical as long as they're willing to pay this policy can so no authorization is required.
[CUSTOMER][POSITIVE] OK, no loss required. Awesome and then.
[AGENT][NEUTRAL] Yes, and then uh we we need to look at inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] So, um, it would be inpatient be so, uh, I guess I should specify so mom delivered a baby um baby is transferred to our hospital and is in the NICU so I generally just copy mom's benefits. So whatever I guess mom's hospital inpatient benefits would be, I'll get those.
[AGENT][NEUTRAL] Mhm. Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, sure, OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so the inpatient benefit is $3500 max per calendar year. I can go ahead and double check to see if any of that has been used. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Looks like um.
[AGENT][NEGATIVE] So none of the inpatient benefit has been used so far this year.
[CUSTOMER][POSITIVE] OK perfect all right well [PII], thank you so much for your help I appreciate it.
[AGENT][NEUTRAL] Of course is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Nope, that is all that I needed.
[AGENT][POSITIVE] All right well thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][POSITIVE] Thank you