AccountId: 011433970860
ContactId: 7a53bc6f-5c9e-4d71-97aa-5d080e796b9b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229839 ms
Total Talk Time (AGENT): 76820 ms
Total Talk Time (CUSTOMER): 82191 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/7a53bc6f-5c9e-4d71-97aa-5d080e796b9b_20250321T14:20_UTC.wav
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[AGENT][POSITIVE] Thank you for
[AGENT][NEUTRAL] Calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. I was wondering if you could assist me in verifying if a patient uh is currently eligible with APL.
[AGENT][NEUTRAL] Yes ma'am I can help you with eligibility. Can I please get your name and your callback number and the name of the facility you're calling from?
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Sure. Um, my name is [PII]. Last name [PII].
[CUSTOMER][NEUTRAL] Uh, the name of the facility I'm calling from is West Kendal Baptist Hospital. And my callback number is [PII]. I have no extension.
[AGENT][POSITIVE] OK, thank you very much, Ms. [PII].
[CUSTOMER][POSITIVE] Mhm. No problem.
[AGENT][NEUTRAL] And policy number.
[CUSTOMER][NEUTRAL] Policy number is 2295829ML8.
[AGENT][NEUTRAL] OK, and what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] OK, let me go ahead and pull her up.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us, and her effective date is [PII].
[CUSTOMER][NEUTRAL] All [PII]. Would you be able to tell me if Ms. [PII] has um like an outpatient annual amount that you guys are willing to help her with for any appointments?
[AGENT][POSITIVE] Yeah ma'am, let me go ahead and give you the benefits.
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. She does have an outpatient calendar year benefit amount of $3500. This is a supplemental insurance policy that's billed secondary to the primary, and it helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, out of the 3 of $3500 that she has in her account, has she used anything as of now?
[AGENT][NEUTRAL] Let me check on that real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She has used $18.92.
[CUSTOMER][POSITIVE] OK, perfect. Alrighty, thank you so much [PII]. May I please have the first letter to your last name and a reference number?
[AGENT][NEUTRAL] Yes, the first letter is A and.
[AGENT][NEUTRAL] And you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Today's date perfect thank you so much, [PII]. I really appreciate all of your help.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] Nope, you've answered all of my questions. Thank you so much.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Mm