AccountId: 011433970860
ContactId: 8b52a0df-1643-4d56-8642-26d0d9ec1351
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157020 ms
Total Talk Time (AGENT): 76821 ms
Total Talk Time (CUSTOMER): 54586 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/8b52a0df-1643-4d56-8642-26d0d9ec1351_20250224T14:34_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. First initial of my last name [PII]. I'm calling from a provider facility because I need to verify eligibility and benefits for a member, please.
[AGENT][POSITIVE] OK, sure, I can assist you with the eligibility and benefits Miss [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] Thank you. And what is the name of the facility?
[CUSTOMER][NEUTRAL] Homestead Hospital.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 01611610. M as in Mike, L as in Lima, and the number 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and then date of birth is [PII].
[AGENT][POSITIVE] Mm, perfect. Thank you. All right. And you said you need eligibility and benefits and it's gonna be outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, outpatient.
[AGENT][NEUTRAL] OK. All right, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans for the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And with this one, we have an outpatient maximum of 1500 per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK. And are you able to see if the member has used um those benefits for this year so far?
[AGENT][NEUTRAL] Mhm, yes, I can let me go ahead and pull that up one moment.
[AGENT][NEUTRAL] OK, as of today, Ms. [PII] has not used her benefits, so she still have the full amount available.
[CUSTOMER][POSITIVE] OK, perfect. All right, thank you so much. That's all I needed to know. Um, do you provide reference numbers for your call?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Um, may I have the first letter of your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much. I hope you have a great rest of your day.
[AGENT][POSITIVE] You're welcome, so thank you for calling ATO. Have a good week.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Right.