AccountId: 011433970860
ContactId: 618e5f42-8025-4df7-bfe6-49388dcb5282
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 343309 ms
Total Talk Time (AGENT): 122402 ms
Total Talk Time (CUSTOMER): 100633 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/2025/03/04/618e5f42-8025-4df7-bfe6-49388dcb5282_20250304T21:26_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Saint Francis Hospital. Uh, I had a patient come into the emergency room, and I'm trying to verify his benefits, the number on the card that told me I had to contact you to get his medical benefit information.
[AGENT][NEUTRAL] OK, sure, I can assist you, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Uh, what is it? Sorry, [PII]. I'm at a different desk today, so give me just a second, let me get that number, um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. All right. And um on the card, do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] No, they, the card he has has a different company on it and so they told me that you guys wouldn't be able to find him based on that ID you would have to use his name and date of birth.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And let me have the spelling of the last name.
[CUSTOMER][NEUTRAL] His last name is [PII], [PII]
[AGENT][NEUTRAL] OK, and the spelling of the first name.
[CUSTOMER][NEUTRAL] First name [PII]
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Do you know his address?
[CUSTOMER][NEUTRAL] The address that we have for him.
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] And that's [PII], correct.
[CUSTOMER][NEUTRAL] Oh yes, sorry, [PII].
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Yeah, I imagine with that. I'm like just making sure.
[CUSTOMER][NEUTRAL] Oh yeah, you never know.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh let me try this one, which is probably not it, but let me try. Um, let's see.
[AGENT][NEUTRAL] And you don't have a social for this number?
[CUSTOMER][NEUTRAL] I do.
[AGENT][POSITIVE] Oh, yay. OK, let's try that.
[AGENT][NEUTRAL] That's easier. There's a lot of [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I kind of figured that'd be a lot of patients to go through um.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] OK, and what's his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect, thank you. OK, I did find the member and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just the verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And with this particular policy, this is a limited hospital indemnity policy, which is a limited policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the ER visit is covered at $50 per visit, maximum of 2 visits per year.
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Max 2 per year has he already met his.
[AGENT][NEUTRAL] Mm, let me check. I don't think he has.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I don't know. I mean it's still the beginning of the year, so I don't know if he has or not.
[AGENT][NEUTRAL] Yeah. Yeah, I don't think he has, but let me double check just to make sure.
[AGENT][NEUTRAL] OK, no, he has not used his benefits for [PII] as of today.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right, that helps and then um are we supposed to bill uh to the address on the card?
[AGENT][NEUTRAL] Mhm, which is supposed to be the one in um.
[AGENT][NEUTRAL] Let's see the IMA.
[CUSTOMER][NEUTRAL] Uh, the one we have is for benefits and a card, yeah, in [PII].
[AGENT][NEUTRAL] You got, [PII].
[AGENT][POSITIVE] Mhm, yeah, that's the correct one.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, I just wanna make sure I had all the correct information in there. OK, I will update his account. Thank you so much for your help.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.