AccountId: 011433970860
ContactId: 60a0e564-5982-4135-84e4-fad204407e13
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194279 ms
Total Talk Time (AGENT): 84235 ms
Total Talk Time (CUSTOMER): 72428 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/60a0e564-5982-4135-84e4-fad204407e13_20250121T15:14_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling for Nicholas Children's Hospital to verify benefits on eligibility.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits, [PII]. Can you please give me your callback number?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And Isabella's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 02443497. M as in Mike, L as in Lima.
[AGENT][NEUTRAL] OK, thank you. Let me pull that policy in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] you that
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. Her effective date is [PII].
[CUSTOMER][NEUTRAL] Uh, they,
[AGENT][NEUTRAL] And this is just to verify her coverage. It's not a guarantee of payment. She has a supplemental insurance policy that is billed secondary to the primary. Her policy helps with deductible, co-pay, and co-insurance. She has an inpatient benefit amount of $6000 and an outpatient benefit amount per calendar year of $6000.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and what is the net amount?
[AGENT][NEUTRAL] I'm sorry, what did you say?
[CUSTOMER][NEUTRAL] Uh, the remaining amount for the $6000.
[AGENT][NEUTRAL] Let me look for you, sir.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] She still has all of her balance left. She's not used anything this year.
[CUSTOMER][NEUTRAL] So the $6000 is remaining, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, is there any group number?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yes sir, let me give you the group number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is 23755.
[CUSTOMER][NEUTRAL] OK, so the effective date is [PII], and it's a supplemental plan, and it's a secondary plan and uh lifetime maximum for in-network benefits is $6000 and it's remaining is $6000 right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. Can you please spell your name with initial?
[AGENT][NEUTRAL] Yes, it's [PII] and the last initial is [PII]
[CUSTOMER][NEUTRAL] OK. Can I get a call reference number?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you, [PII], for your information. Have a great day. Bye.
[AGENT][POSITIVE] You too [PII] thank you for calling APL you have a good week. Bye bye sir.
[CUSTOMER][NEUTRAL] Yeah bye.