AccountId: 011433970860
ContactId: 89a23915-0666-4bb1-bc77-8c4a13ef5018
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211679 ms
Total Talk Time (AGENT): 77760 ms
Total Talk Time (CUSTOMER): 42220 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/89a23915-0666-4bb1-bc77-8c4a13ef5018_20250207T21:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, sir. I'm calling from Nicholas Children's Hospital. I needed to verify eligibility for a member.
[AGENT][POSITIVE] All right, I'm happy to check eligibility. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] I have 02419362.
[AGENT][POSITIVE] All right, thank you so much. Let me pull this up here, one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Alright, let me read this policy number back. I copied down 02419862.
[CUSTOMER][NEUTRAL] No, the last, let me just say it again. 12419362.
[AGENT][POSITIVE] It's completely off on that. I'm so sorry.
[CUSTOMER][NEUTRAL] No, it's OK.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Right, that doesn't.
[AGENT][NEUTRAL] Can you spell [PII]'s last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] So it looks like the patient does have an active plan. The effective date on this is going to be [PII]. We are the secondary insurance, so this does cover deductible, co-pay and co-insurance. The primary does not.
[CUSTOMER][NEUTRAL] OK, what's the benefit for outpatient diagnostics?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] The outpatient benefit on this plan, it looks like is a calendar year max of 8700.
[CUSTOMER][NEUTRAL] Sorry, you said 8700?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, do you still have funds available?
[AGENT][NEUTRAL] Uh let me see if they've used anything.
[AGENT][NEGATIVE] Looks like the patient has the full amount still to use for the year. Nothing's been used.
[CUSTOMER][NEUTRAL] OK. Do you have reference numbers for the call?
[AGENT][NEUTRAL] Yeah, absolutely. Call references my name with my last initial and then today's date. My name is [PII], that's [PII] My last initial is [PII].
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][POSITIVE] OK. Thank you. Have a good day. Bye-bye.
[AGENT][NEUTRAL] You too, bye.