AccountId: 011433970860
ContactId: 84a7ab82-32d4-42cc-89f8-c1f10dd39511
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286859 ms
Total Talk Time (AGENT): 75829 ms
Total Talk Time (CUSTOMER): 82478 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/84a7ab82-32d4-42cc-89f8-c1f10dd39511_20250107T13:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, um, I'm just here to verify the eligibility of one of our patients.
[AGENT][NEUTRAL] OK, I can help you. Your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And [PII], what's the policy number?
[CUSTOMER][NEUTRAL] The policy number is 02519038.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, that'll be.
[CUSTOMER][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hey [PII], what's uh the callback number for that?
[CUSTOMER][NEUTRAL] Just one moment, ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sorry about this.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] Should say
[CUSTOMER][NEUTRAL] So what is this?
[CUSTOMER][NEUTRAL] So for verifying the insurance APL.
[CUSTOMER][NEUTRAL] OK, just tell me.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] Yeah, so that number is gonna be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name is
[CUSTOMER][NEUTRAL] [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII], and all you're needing is the effective date and if the policy is active?
[CUSTOMER][NEUTRAL] Yes,
[AGENT][NEUTRAL] OK, I show the policy effective date is [PII]. Uh, this policy is active at this time.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Specifically, may I ask if they're eligible for emergency services?
[AGENT][NEUTRAL] Let me get that information for you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Is this urgent care or emergency room?
[CUSTOMER][NEUTRAL] Emergency room.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So emergency room can be considered under the outpatient.
[AGENT][NEUTRAL] Uh, benefit under the policy and I'm showing the calendar year maximum.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] Um, so we don't really have.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] The outpatient calendar year maximum is $300 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it'll be her out of pocket max then.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Uh, this is the amount that the policy will cover of total charges up to 300 per per covered person per calendar year and of course the information provided is verification, not a guarantee of payment. Did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, no, that's all. I'll just need a reference number for this call.
[AGENT][NEUTRAL] My name in today's date, [PII].
[CUSTOMER][NEUTRAL] So it'd be [PII] um.
[CUSTOMER][NEUTRAL] 1
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh, and this is a per calendar day. I said per calendar year, but it's actually 300 per covered person per calendar day.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII]. Hope you have a great day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Alrighty. You're welcome, [PII]. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.