AccountId: 011433970860
ContactId: 94b6b252-310e-422d-bff7-555c610cb8b9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193259 ms
Total Talk Time (AGENT): 89080 ms
Total Talk Time (CUSTOMER): 74072 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/94b6b252-310e-422d-bff7-555c610cb8b9_20250429T22:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yeah, good day, um, I'm calling from a facility from Miami Cancer Institute regarding a patient. I just wanted to, um, your eligibility please.
[AGENT][NEUTRAL] Yeah, I can take eligibility for you. Um, what was your name please?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][POSITIVE] Thank you. And then [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure, um, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Um, I, he has two different policy numbers that I'm seeing, so I'm not sure which one is the right one. I don't know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's OK, we can check it.
[CUSTOMER][NEUTRAL] OK, alright, give me one second, let me pull that up.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] All right, um, let's see, alright, so the first one I have is.
[CUSTOMER][NEUTRAL] 01947531.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] Perfect. OK, and this was for um medical correct?
[CUSTOMER][NEUTRAL] Yes, for medical.
[AGENT][NEUTRAL] OK, yeah, so, um, this is the correct policy number, uh, and this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] OK, perfect. Is there like a cap um in the amount?
[AGENT][NEUTRAL] Um, yes, give me just a moment.
[AGENT][NEUTRAL] Of course I will let you know verification of coverage is not a guarantee of payment for claims, um, so inpatient, uh, that is per calendar year it's $5000 max um outpatient is also $5000 max per calendar year. Did you want me to see if any of that has been used?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] Sure, one moment.
[AGENT][NEUTRAL] And this was for [PII] correct?
[CUSTOMER][POSITIVE] Yes for [PII] mhm.
[AGENT][NEUTRAL] OK, um, so [PII] has used, um, all of that $5000 outpatient benefit.
[CUSTOMER][NEUTRAL] OK perfect I'll take a note of that then thank you. Is there like a reference number for the phone call by the way?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] It would, yeah, it would just be my first name, last initial and today's date and so my name is spelled [PII] And is there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that'll be it, [PII]. Thank you so much for your help. I hope you have a great day bye bye thanks.
[AGENT][POSITIVE] Alright, of course, thanks for you too thanks bye bye.
[CUSTOMER][NEUTRAL] Bye.