AccountId: 011433970860
ContactId: 968d1bb5-86f6-470e-bbb3-be2fcdee1e8d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 134869 ms
Total Talk Time (AGENT): 61175 ms
Total Talk Time (CUSTOMER): 36116 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/968d1bb5-86f6-470e-bbb3-be2fcdee1e8d_20250212T16:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, sir. I wanted to call to check eligibility and benefits for a patient, please.
[AGENT][POSITIVE] All right. I'm happy to check benefits and eligibility. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number I have is 1993963.
[AGENT][POSITIVE] Alright, thank you so much. And if I could grab your first name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then patient name and date of birth?
[CUSTOMER][NEUTRAL] Sorry, [PII], [PII].
[AGENT][NEUTRAL] Thank you. Uh, the patient plan is active. The effective date is [PII]. We are the member secondary insurance, so this is gonna cover deductible, co-pay, co-insurance. The primary does not.
[CUSTOMER][NEUTRAL] OK. Um, and then how much?
[CUSTOMER][NEUTRAL] Do you guys cover for outpatients?
[AGENT][NEUTRAL] Uh, let's
[AGENT][NEUTRAL] E for outpatient.
[AGENT][NEUTRAL] Uh, looks like the member's plan has an outpatient benefit of $500 and that's per occurrence.
[CUSTOMER][NEUTRAL] OK, oh, and then do they have any inpatient benefits?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah, it looks like the inpatient benefit for the calendar year is 2250.
[CUSTOMER][NEUTRAL] Per current or just total?
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] No, per occurrence or just total for the year?
[AGENT][NEUTRAL] Uh, that's total for the year.
[CUSTOMER][NEUTRAL] Have they used any?
[AGENT][NEUTRAL] Uh, let's see here, one moment.
[CUSTOMER][NEUTRAL] for
[AGENT][NEGATIVE] Uh, looks like nothing has been used for the year.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] Thanks you as well bye.
[AGENT][NEUTRAL] Bye bye.