AccountId: 011433970860
ContactId: 8fab8985-2334-45e7-9042-24aa6cf4d215
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296899 ms
Total Talk Time (AGENT): 146261 ms
Total Talk Time (CUSTOMER): 71238 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/8fab8985-2334-45e7-9042-24aa6cf4d215_20250310T18:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to verify eligibility.
[AGENT][NEUTRAL] Sure, I can take eligibility for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] D 43732202
[AGENT][NEUTRAL] OK, so that's not one of our policy numbers, [PII], that is through, uh, they're called 90 Degrees. Um, I can give you their information and transfer you to them if you'd like, um, or if you have a uh a social security number, I can see if they have a policy with us.
[CUSTOMER][NEUTRAL] OK, I have a social.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And what was the name for the patient?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, do you have a date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that, [PII]. Uh, so she does have a, it is a limited indemnity medical plan with us. Uh, it is currently active. That effective date was [PII]. It's possible she might have some other benefits or coverages through 90 Degrees, um, but this is what she has with us.
[CUSTOMER][NEUTRAL] OK, does the one with you guys cover emergency room visits?
[AGENT][NEUTRAL] Oh, let me check that. Give me just a moment.
[AGENT][POSITIVE] Alright, bear with me just a moment. I appreciate your patience.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this policy is very specific and of course very limited as to what it does and does not cover um, of course I will let you know verification of coverage is not a guarantee of payment for claims, um, so it's not necessarily the facility type, um, did she have to have a surgery or was she confined there for more than a day?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, so there is, uh, was she admitted, um, well, how long was she there? Just the one day?
[CUSTOMER][NEUTRAL] Um, yes, just a few hours.
[AGENT][NEUTRAL] OK. A few hours. OK. So the only benefits for this policy, there's a hospital ad excuse me, a hospital admission benefit of $1000 per day. Of course, there's a confinement benefit, um, surgical benefit, and then diagnostic testing benefit. So that includes uh like medical imaging tests.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And those are the only benefits that she has for this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, that's what I needed to know. Um, then, uh, could you, um, when our registrar scanned her card in, we didn't get the back of the cards, so I'm just been googling trying to find numbers to call. Um, could you give me that number to call about the other plan?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh sure.
[AGENT][NEUTRAL] Absolutely give me just a moment let me get that for you and it might have been, it's a bit confusing, um, it might have been the same number that you called for us, um, but they're the prompts at the beginning are a little bit confusing, so their phone number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And to reach them you would select option one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, perfect. And then [PII], could I get a call reference number?
[AGENT][NEUTRAL] Oh sure, that would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that's perfect thank you so much.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.