AccountId: 011433970860
ContactId: 66e2308e-8de8-479f-b507-a5253dbec5b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190000 ms
Total Talk Time (AGENT): 77127 ms
Total Talk Time (CUSTOMER): 117477 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/66e2308e-8de8-479f-b507-a5253dbec5b7_20250207T19:51_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I can keep my name is [PII] from looking to, um, I'm a provider looking to see if I could verify the eligibility and benefits for a member.
[AGENT][NEUTRAL] OK, I can verify eligibility benefits, of course, and your name again? I'm so sorry.
[CUSTOMER][POSITIVE] Appreciate, appreciate your help.
[CUSTOMER][POSITIVE] Sounds great. Thanks so much. Uh, it's [PII] from [PII] I M. Thank you for your help.
[AGENT][POSITIVE] You're fine, that's cool. OK, and what's that policy number, please?
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, it'll be 02581892.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][POSITIVE] Yeah, thank you as well.
[CUSTOMER][NEUTRAL] Of course, [PII].
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth, please.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I have a Mr. [PII], born on [PII].
[AGENT][NEUTRAL] OK, I'm showing his effective date is [PII]. He is active on the policy and what benefits are you needing for the patient?
[CUSTOMER][NEUTRAL] This would, this would be for outpatient hospital facility benefits.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He's having a procedure done this Wednesday, yeah, [PII], yeah.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment, just a verification of coverage. With this policy, we are secondary. We help with primary insurance, deductible, co-pay, and co-insurance, and it shows he has an outpatient benefit that pays up to $500 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so he has per 500 per count of days outpatient hospital best benefits, it'll be 5 up to 500 per day. OK, daily. Got you. OK. All right, perfect.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And it does and you just say pay the copays deductibles and the uh.
[AGENT][NEUTRAL] Co-insurance, yes.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] And car insurance. I was, yeah, I couldn't, couldn't get that one out of my mouth sorry.
[CUSTOMER][NEUTRAL] It's like it's, it was like, you know, it's like I said I like there's one missing I know.
[AGENT][NEUTRAL] And you know,
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Sorry, I need more coffee. Alright, and, uh, how do I how do I pronounce and spell your name to make sure I have it right, mhm.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] It's [PII], last initial [PII].
[CUSTOMER][POSITIVE] Perfect. And then do you have a call reference number we can use for this information?
[AGENT][NEUTRAL] Uh, no, sir, but you can use my name in today's date if you like.
[CUSTOMER][NEUTRAL] Yeah, I'll just key QQ, uh, let's see, [PII] is that OK?
[AGENT][NEUTRAL] OK. Well, um, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Besides the $500 a day, that would be, that's all he has, right? Just wanna make sure before I let you go.
[AGENT][NEUTRAL] Uh, yes, for outpatient. Yes, sir.
[CUSTOMER][POSITIVE] Outpatient hospital, and then you also said it is effective as of the first day of this year. Is that correct as well? Onegen first? OK, got it. Perfect. All right. Well, thank you for your help and very kind and have a wonderful day. Thank you so much. Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You too and thanks for calling APL. Have a great weekend.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] You too bye bye now.
[AGENT][NEUTRAL] Bye.