AccountId: 011433970860
ContactId: 7c9aa9b1-9feb-4a3a-8f83-16793615d577
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267809 ms
Total Talk Time (AGENT): 140057 ms
Total Talk Time (CUSTOMER): 96111 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/7c9aa9b1-9feb-4a3a-8f83-16793615d577_20250611T22:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] my [PII], and I was calling to verify benefits for a patient.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with benefits. Can I please get your callback number and the name of your facility?
[CUSTOMER][NEUTRAL] Yes, callback number is gonna be a direct line of [PII].
[CUSTOMER][NEUTRAL] And the name of the facility is Texas Children's Hospital.
[AGENT][NEUTRAL] OK, thank you very much. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, it's [PII], and the date of birth is [PII]. Policy number that I have is going to be 01612908.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] And [PII], do you spell your name with a [PII] or an [PII]?
[AGENT][NEUTRAL] It's [PII] [PII]
[CUSTOMER][POSITIVE] Perfect. That's what I put and the initial to your last name, please?
[AGENT][NEUTRAL] Oh, good. It's [PII]
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] You're welcome. OK, so I do show that Miss [PII], let me see, she does have an active policy. Her effective date is going to be
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. This is a supplemental insurance policy. It helps with deductible, co-pay, and co-insurance. She has an inpatient benefit amount per calendar year of $5000 and then she also has an outpatient deductible amount.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I'm sorry, not, not a deductible, an outpatient calendar year benefit amount of $5000.
[AGENT][NEUTRAL] With an outpatient deductible of $250.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] This is OK.
[CUSTOMER][NEUTRAL] And has she met any of that?
[AGENT][NEUTRAL] Let me check for you real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No ma'am, nothing's been used for the year of [PII].
[CUSTOMER][NEUTRAL] OK, perfect. OK, so then what is her responsibility portion? So just she has to, it, it'll go subject to the deductible, right? The $250?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so she doesn't have a co-insurance or anything like that?
[AGENT][NEUTRAL] No, ma'am. Um, this policy helps with, um,
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] With that.
[AGENT][NEUTRAL] Co-insurance.
[CUSTOMER][POSITIVE] OK, yeah. Perfect.
[CUSTOMER][POSITIVE] Perfect. OK. All right. That's what I needed to know and um
[CUSTOMER][NEUTRAL] I guess, uh, since it's a supplement it doesn't make a difference. It's kind of like an indemnity, so it'll cover regardless because it's just to help out with the deductible and everything else so.
[CUSTOMER][NEUTRAL] Uh, OK, so if I can get it right, that's, that's how it goes, right? Yeah.
[AGENT][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] Let me look real quick because it's for covered facilities. Let me check her policy real quick. What kind of facility is it that she's gonna be going to?
[CUSTOMER][NEUTRAL] It's a hospital.
[AGENT][NEUTRAL] A hospital for, is she going inpatient?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, outpatient MRI's.
[AGENT][NEUTRAL] OK, alright, and is it going to be like an MRI imaging center?
[CUSTOMER][NEUTRAL] No, no, no, it's gonna be at the hospital outpatient.
[AGENT][NEUTRAL] OK, like ambulatory then.
[CUSTOMER][NEUTRAL] Yeah, like, yeah, it's just gonna be outpatient hospital. She'll come here to the hospital, just do it, you know, outpatient, yeah.
[AGENT][NEUTRAL] OK. Yeah, OK. OK, yes, ma'am.
[AGENT][NEUTRAL] Yes. OK. Yes, ma'am. So it does help with deductible, co-pay or co-insurance.
[AGENT][NEUTRAL] Then
[CUSTOMER][POSITIVE] Perfect. OK, that's awesome. OK, so then all I need is a call reference number and we are good.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yes, ma'am, um, you can use my name [PII] and today's date for your reference.
[CUSTOMER][POSITIVE] Thank you so much. You have a wonderful evening.
[AGENT][POSITIVE] And I hope you have a wonderful you too, Ms. [PII]. Thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye bye.