AccountId: 011433970860
ContactId: 8d18d4f1-46cc-4fb1-97f1-2fa2fb253688
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 152990 ms
Total Talk Time (AGENT): 88130 ms
Total Talk Time (CUSTOMER): 58396 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/8d18d4f1-46cc-4fb1-97f1-2fa2fb253688_20250129T14:00_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling from Stuart Coral Gables Hospital. I'm trying to verify a member's eligibility and benefits. They have your insurance as secondary.
[AGENT][POSITIVE] Right now, it would be a pleasure to assist you with the eligibility and benefits this morning. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Says here 02534281 M like Mary, L like Larry 7.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII] and I have a date of birth of October, I'm sorry, [PII]. I don't know why I'm thinking of October. I don't know where I'm at. How's that?
[AGENT][POSITIVE] I do that sometimes too. It's just the funniest things come out of my mouth and I'm like, where did that come from?
[CUSTOMER][NEUTRAL] Mines somewhere else, that's what it is.
[AGENT][NEUTRAL] I
[AGENT][POSITIVE] Or, or just being human, and that's a good thing.
[CUSTOMER][NEUTRAL] Yeah, it is.
[AGENT][NEUTRAL] All right. And we've got [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 527 62 and you are needing benefits and eligibility for [PII] and I can help you with that. I'm showing that his policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, yes. Mhm.
[AGENT][NEUTRAL] And yes, this is his secondary policy to his primary insurance.
[AGENT][NEUTRAL] And what type of benefits are you needing?
[CUSTOMER][NEUTRAL] Let me see what he's having. He is having an EGD done, so it's an outpatient surgery of the esophagus.
[AGENT][NEUTRAL] Alright, I can help you with that benefit. Now he does have outpatient coverage, and that benefit amount is $1500 and that is a per calendar day benefit.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And that is what we can pay toward his deductible co-pay or coinsurance of his major medical. And Rayna, if you would please note that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. What is the initial to your last name?
[AGENT][NEUTRAL] [PII], and if you need a reference number, it would be my name and today's date.
[AGENT][NEUTRAL] And is there anything else I can help you with?
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] No, that is it. Thank you.
[AGENT][POSITIVE] Well, it's been such a pleasure to assist you with those benefits. Thank you for calling [PII] and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.