AccountId: 011433970860
ContactId: 89458470-aed1-493a-b151-d5ec0b2ecc0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153949 ms
Total Talk Time (AGENT): 75481 ms
Total Talk Time (CUSTOMER): 50920 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/89458470-aed1-493a-b151-d5ec0b2ecc0f_20250303T17:19_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Baptist Memorial Hospital. Need to get benefits on a patient, please.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a call back number for you?
[CUSTOMER][NEUTRAL] Uh yes, it's [PII]. That's correct.
[AGENT][NEUTRAL] And what's the policy number of the member that you're inquiring eligibility for today?
[CUSTOMER][NEUTRAL] It is 02439234.
[AGENT][NEUTRAL] Give me that policy number one more time, [PII].
[CUSTOMER][NEUTRAL] 02439234.
[AGENT][NEUTRAL] And what's this member's name and date of birth that you request eligibility for?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling to verify outpatient benefits?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This patient's policy has been active since [PII] and is currently active. [PII], she has maximum benefit amount of $2000 per calendar year for outpatient services with a $100 deductible, and this is not a guaranteed benefit, just a disclaimer of the policy coverage.
[CUSTOMER][NEUTRAL] Has she made her deductible?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] She has not, she has not utilized any of her benefits for [PII].
[CUSTOMER][NEUTRAL] OK, so after she meets the $100 deductible, does it pay a percentage up to $2000 or?
[AGENT][NEUTRAL] It will, it will pay up to.
[AGENT][NEUTRAL] What, so how this works is whatever went towards the deductible, co-pay and co-insurance to the primary.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We will cover for her because this is a gap insurance.
[CUSTOMER][MIXED] OK, but does it pay like
[AGENT][NEUTRAL] No, it's not.
[CUSTOMER][NEUTRAL] I know her her major.
[AGENT][NEUTRAL] It's not a percentage. So if she has $2000 that went towards her deductible copay and co-insurance, then we would cover the $2000.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, I got you. Alright, perfect. Alright, and you need, uh, do you have a call reference number?
[AGENT][NEUTRAL] Don't provide those [PII], however, you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] OK, [PII]
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] OK perfect thank you so much have a great day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Bye bye.