AccountId: 011433970860
ContactId: 88a43086-c956-4994-bdf0-4437d0076b14
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227190 ms
Total Talk Time (AGENT): 89159 ms
Total Talk Time (CUSTOMER): 66113 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/88a43086-c956-4994-bdf0-4437d0076b14_20250605T13:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I'm calling for benefits and eligibility for a patient.
[AGENT][NEUTRAL] OK, I can assist with that. And may I have your name?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you [PII] and your call back number please?
[CUSTOMER][NEUTRAL] Um, it would be [PII].
[AGENT][POSITIVE] OK, thank you, [PII]. I am ready for the policy number.
[CUSTOMER][NEUTRAL] OK, I have 021-35061.
[AGENT][NEUTRAL] Thank you. Let me just repeat that to confirm. I have that as 02135061.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you very much. And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It is for [PII], and it's [PII].
[AGENT][POSITIVE] OK, thank you very much and I can certainly help you with eligibility and benefits would that be for inpatient or outpatient?
[CUSTOMER][NEUTRAL] It'll be outpatient.
[AGENT][NEUTRAL] OK, thank you. The member shows effective as of [PII]. This policy shows active as a supplemental medical and for outpatient benefits, please note verification of benefits provided does not guarantee payment. The member has a $6000 calendar year max.
[AGENT][NEUTRAL] For outpatient services, she also has a $100 deductible.
[AGENT][NEUTRAL] Or account or your deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and is, do you know if any of that is met yet?
[AGENT][POSITIVE] OK, I can certainly check that for you. Give me one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just recheck myself, almost done.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you so much for your patience. Um, she has not met her $100 deductible and has not used anything towards her outpatient max, of course.
[CUSTOMER][NEUTRAL] OK, um, so the patient must meet the deductible first and then y'all will pick up.
[CUSTOMER][NEUTRAL] Like at 100% towards that max, correct?
[AGENT][NEUTRAL] We pick up once she meets her deductible, we will pick up to that max for deductible co-pay, co-insurance based on coverage services. That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and y'all don't cover like office visits, correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and then no, we don't need no pre-ear with y'all correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and I believe that is all I needed um do you do reference numbers or anything?
[AGENT][NEUTRAL] You're welcome. We do not use your reference numbers. You can use my name [PII]. Last initial is [PII], and today's date.
[CUSTOMER][POSITIVE] OK, and thank you so much.
[AGENT][POSITIVE] Thank you for calling HL. You have a great day. Thank you.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][NEUTRAL] Mm bye.