AccountId: 011433970860
ContactId: 8f9faa1a-4b70-4f99-9003-90ab2a9369de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200800 ms
Total Talk Time (AGENT): 105438 ms
Total Talk Time (CUSTOMER): 59538 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/8f9faa1a-4b70-4f99-9003-90ab2a9369de_20250328T16:10_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, good morning, [PII]. This is [PII] calling you from South Miami Hospital. How are you?
[AGENT][POSITIVE] I'm doing well, [PII]. How are you doing?
[CUSTOMER][NEUTRAL] For ID number 02487978.
[AGENT][POSITIVE] Thank you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And the the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Yes, a patron's last name is [PII], first name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, and the phone was breaking up, so I, I did not hear it correctly. Were you calling for claim status or eligibility for Elier?
[CUSTOMER][NEUTRAL] Eligibility.
[AGENT][POSITIVE] All right, I can help you with that.
[AGENT][NEUTRAL] Uh, [PII], I'm showing that the policy is active. The effective date is [PII], and this is a secondary policy to his major medical insurance. Any specific benefits you're needing?
[CUSTOMER][POSITIVE] Yes, outpatients, um, benefits for the hospital.
[AGENT][POSITIVE] All right, thank you. Now.
[AGENT][NEUTRAL] He does have outpatient coverage. That benefit amount is $4250 and that is a per calendar day benefit.
[AGENT][NEUTRAL] And if you would please note that is a verification of coverage, not a guarantee of payment. And again, that's a per day benefit.
[CUSTOMER][NEUTRAL] OK, I think.
[CUSTOMER][POSITIVE] Perfect. And does he have met any of it?
[AGENT][NEUTRAL] Well, since it is a per calendar day benefit.
[AGENT][NEUTRAL] It's not a per calendar year, it's per calendar day.
[CUSTOMER][NEUTRAL] OK, so as of right now, he has not used any of it.
[AGENT][NEUTRAL] No ma'am, because it is a per calendar day is it for today?
[CUSTOMER][NEUTRAL] No, it's for a surgery he's having on the [PII].
[AGENT][NEUTRAL] On the [PII].
[CUSTOMER][NEUTRAL] So, um, that's why we wanted to confirm, yes, so the [PII], he's having an outpatient surgery and just we need to confirm for the to verify for his, you know, if he has any co-payments or anything else.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right. So with this policy, it is paid, uh, that benefit amount is payable per day. So I would not.
[AGENT][NEUTRAL] Know if he's used any of that benefit for [PII] since it is in the future.
[CUSTOMER][NEUTRAL] OK, not a problem. I just needed to confirm, but he has outpatient hospital benefits. Perfect. OK, [PII], may I have a reference number for the call, please?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] The reference number is my name and today's date, and I spell my name [PII], and [PII], it's been a pleasure to assist you with those benefits. Anything else I can help you with today?
[CUSTOMER][POSITIVE] That's it. Thank you so much. Have a great weekend.
[AGENT][POSITIVE] I hope you have a great weekend as well, [PII]. Thank you for calling APL and take care.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.