AccountId: 011433970860
ContactId: 64cb3359-ecc2-42d7-bd69-389bd654885f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 131539 ms
Total Talk Time (AGENT): 58303 ms
Total Talk Time (CUSTOMER): 44463 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/64cb3359-ecc2-42d7-bd69-389bd654885f_20250619T14:04_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, this is Covenant Healthcare calling to see if I can get eligibility benefits for a patient, please.
[AGENT][POSITIVE] OK, I can help you with eligibility and benefits. Could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII], and the number is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And do you have a policy number for that patient?
[CUSTOMER][NEUTRAL] Um, yes, it says member ID is gonna be 02635531.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, I show this policy is active and effective [PII]. And is this for outpatient benefits or?
[CUSTOMER][NEUTRAL] Uh, yeah, for the ER.
[AGENT][NEUTRAL] It's not a guarantee of payment, basic outline policy.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] I'm sorry, what was that, honey?
[AGENT][NEUTRAL] It's not a guarantee of payment basic outline of the policy, um, for his benefits, ER.
[AGENT][NEUTRAL] So this is just like a supplemental policy. So the benefit is $300 payable per day, 1 day per calendar year for emergency room.
[CUSTOMER][NEUTRAL] One day, OK, so $300 co-payment.
[AGENT][NEUTRAL] No, it's, that's the max that we'll pay.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, the max that it will pay. OK, so how much is it for ER visit? Does it state that?
[AGENT][NEUTRAL] That that's the amount that we'll pay for an ER visit. The maximum is 300.
[AGENT][NEUTRAL] So it's a supplemental policy, so that's, so whatever the bill is the the most we will pay is $300 per day.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and then you said it was active as of [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, thank you so much. I will note this in the account. I appreciate your help.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][NEUTRAL] OK. Bye.
[CUSTOMER][NEUTRAL] Bye