AccountId: 011433970860
ContactId: 62eb9512-e40e-43e7-aa9a-2dbd55e4edad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210720 ms
Total Talk Time (AGENT): 97156 ms
Total Talk Time (CUSTOMER): 79717 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/62eb9512-e40e-43e7-aa9a-2dbd55e4edad_20250512T13:27_UTC.wav
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[AGENT][POSITIVE] Thank you for calling API. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from uh Nicholas Children's Hospital. How are you?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] Yeah, I'm doing great as well thank you for asking so uh I'm calling in to uh check the member's eligibility would you be able to assist me with that?
[AGENT][POSITIVE] I'm sure, [PII], I can assist you with benefits. And first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Sure, uh, my call back number would be [PII], uh, with the extension of [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Sure, uh, the policy number is 1988283.
[CUSTOMER][NEUTRAL] M as in mango, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Sure, uh, the patient's name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Uh, it's for outpatient hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you need to verify benefits or claim status?
[CUSTOMER][NEUTRAL] Uh just the benefits.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, for inpatient hospital, if the patient is admitted, we cover up to $7150 per calendar year, and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim. And for outpatient hospital, we cover up to $500 per day. And again, that's for the copay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][POSITIVE] Alright, uh thank you for that, so.
[CUSTOMER][NEUTRAL] Uh, uh, that's pretty much it. So just, um, would you be able to like spell out your name for me please?
[AGENT][NEUTRAL] Um, yes, my name is [PII]. Um, it's spelled [PII], and if you need a reference number, it will be my name and today's date.
[CUSTOMER][NEUTRAL] Yeah, uh, I'm sorry, uh, could you repeat that again? Yeah.
[AGENT][NEUTRAL] Um, it's E, V like Victor, I E and last initial [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you for that. uh, so the call reference number is also gonna be your name, right?
[AGENT][NEUTRAL] Yes, sir. My name and today's date.
[CUSTOMER][POSITIVE] OK, uh thank you for that once again. Uh, so that's pretty much it and it's been an absolute pleasure talking to you. Uh, have a wonderful day.
[AGENT][POSITIVE] Yeah, thank you [PII] for calling APL. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Yeah, that's it thank you.
[AGENT][POSITIVE] OK. Mhm. I thank you again for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] Bye.