AccountId: 011433970860
ContactId: 88ea0ff3-ccfc-41c0-a925-2ed018d3060e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209080 ms
Total Talk Time (AGENT): 75680 ms
Total Talk Time (CUSTOMER): 50810 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=2.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/88ea0ff3-ccfc-41c0-a925-2ed018d3060e_20250602T16:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi. Um, I need to know if a patient is active with you all.
[AGENT][POSITIVE] Sure I can help with eligibility. Can I get your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and a good callback number is [PII].
[AGENT][NEUTRAL] And do you have the patient's uh policy number?
[CUSTOMER][NEUTRAL] Yes, it's 026.
[CUSTOMER][NEUTRAL] 03933. And the patient's name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Alright, I'm showing that this policy is active with an effective date of [PII].
[CUSTOMER][POSITIVE] Perfect. Do they have um an amount that they are allowed up to for hospital patients?
[AGENT][NEUTRAL] Give me one moment, let me pull up their policy.
[CUSTOMER][POSITIVE] Oh, thank you.
[AGENT][NEUTRAL] And then I will say that this is secondary gap insurance so when filing a claim under this policy, we will need the primary insurances EOB along with that claim.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, no worries.
[AGENT][NEUTRAL] And I'm sorry, did you ask for inpatient or outpatient um benefits?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Outpatient, OK, give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And this is just a verification of benefits, not a guarantee of payment. It looks like she has a combined inpatient and outpatient maximum of up to $3000 per calendar year and that's combined.
[CUSTOMER][POSITIVE] OK, perfect. And has she used anything towards that this year?
[AGENT][NEUTRAL] Give me just one moment and I'll check.
[AGENT][NEUTRAL] It looks like she has used that.
[CUSTOMER][NEUTRAL] She's used the whole thing?
[AGENT][POSITIVE] Yes ma'am, that is what I'm showing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] And I will double check that.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes I am showing that she's used it.
[CUSTOMER][NEUTRAL] OK, perfect. Um, do I get a reference number for the call, please?
[AGENT][NEUTRAL] So we don't have reference numbers, but you can use my name and last initial in today's date, so [PII], last initial [PII] and today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII]. I hope you have a great day.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye.