AccountId: 011433970860
ContactId: 7237b380-4309-4787-a3d0-cb0fee09a1af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163639 ms
Total Talk Time (AGENT): 89650 ms
Total Talk Time (CUSTOMER): 80181 ms
Interruptions: 5
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/7237b380-4309-4787-a3d0-cb0fee09a1af_20250228T15:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, I'm a provider and I need to verify eligibility for a patient that we have here in the emergency room.
[AGENT][POSITIVE] OK, sure, I can assist you with the eligibility. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes, my name is [PII] A. Phone number [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I'm gonna give you what I have, but I believe this is the inpatient number. I know you guys have two, but I'm verifying outpatient. The policy number is 022.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 557-71 ML 7
[AGENT][NEUTRAL] All right. Thank you. One moment, let me pull that information.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] First name [PII], last name [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. All right, and before I give you any benefit or eligibility information, this is not a guarantee of payment, just a verification of coverage, Ms. [PII]. And we have an effective date of [PII]. It is active at the moment and this is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] This is an ER visit, correct?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and this is not a guarantee of payment, just a verification of coverage. It looks like um this member has a deductible for an ER visit of 200 and then after that we pay up to 1000 per person per calendar year.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] looks like um this member has a deductible for an ER visit of 200.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So he still does have to pay something even with this insurance.
[AGENT][NEUTRAL] 200. Mhm, yes.
[CUSTOMER][NEUTRAL] The 200 and that's once a year?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] It hasn't been satisfied, right?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] That's per occurrence, the 200 is per occurrence. So it's every time he goes into the emergency room.
[AGENT][NEUTRAL] He has that $200 deductible. Mhm. And then after that we pay up to £1 to you. Mhm.
[CUSTOMER][NEUTRAL] Oh, interesting.
[CUSTOMER][POSITIVE] Oh wow, so
[CUSTOMER][NEUTRAL] Oh, OK, so he, OK, got it, um, alrighty and what's your first name and the first letter of your last name?
[AGENT][NEUTRAL] My first name is [PII], that's [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] at the same time.
[CUSTOMER][NEUTRAL] know.
[CUSTOMER][POSITIVE] Perfect. OK, thank you so much so that's all I needed.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. You have a good day, Miss [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You too thank you bye bye.