AccountId: 011433970860
ContactId: 767ec955-2d72-4967-b40f-f8bd9b163cb6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239179 ms
Total Talk Time (AGENT): 99972 ms
Total Talk Time (CUSTOMER): 56175 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/767ec955-2d72-4967-b40f-f8bd9b163cb6_20250508T19:45_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] Yes, calling to verify member benefits.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] First name is [PII] last initial [PII] and if I can have the spelling of your first name.
[AGENT][NEUTRAL] Sure, that's [PII]. Last initial [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02458533 ML 8
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]. Last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And you say you need benefits. What type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] Um, for outpatient hospital, um, what do you need, like the procedure or the codes?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Mm. No, I just need to know if it was outpatient or inpatient hospital or office. OK. All right, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our secondary supplemental plans to the major medical. With this policy, this member has an outpatient maximum of 5000 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Oh OK, OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And just the effective date please.
[AGENT][NEUTRAL] OK, let me get that for you one moment.
[AGENT][NEUTRAL] Mm, one minute. OK.
[AGENT][NEUTRAL] OK, so we have an effective date of
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, are you able to verify if the patient has any accumulation?
[AGENT][NEUTRAL] Yeah, I can check and see if they have used any of the benefits and Mr. [PII], what, what's the name of the facility you're calling from from my note?
[CUSTOMER][NEUTRAL] Mount Sinai Medical Center.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let's see how much she has used. One moment.
[AGENT][NEUTRAL] Um, OK, as of today, she has not used her benefits. She still have the full amount available.
[CUSTOMER][POSITIVE] Perfect. And just the reference number, please.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day. Good afternoon.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.