AccountId: 011433970860
ContactId: 99b58937-8ba5-45a9-94ba-7b0843697598
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175339 ms
Total Talk Time (AGENT): 81777 ms
Total Talk Time (CUSTOMER): 58445 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/99b58937-8ba5-45a9-94ba-7b0843697598_20250303T14:47_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Memorial Herman Hospital. We have a patient scheduled for an inpatient procedure at our facility. I was needing to verify benefits and eligibility.
[AGENT][NEUTRAL] OK, sure. I can assist you with benefits and eligibility, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 01612918
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you said you need inpatient benefits and eligibility, correct?
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK. Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment, and this is one of our secondary supplemental plan to the major medical.
[AGENT][NEUTRAL] And we have an inpatient maximum of 5000 per person per calendar year after a 250% deductible.
[CUSTOMER][NEUTRAL] I'm sorry, you said the inpatient max was how much?
[AGENT][NEUTRAL] 5000
[CUSTOMER][NEUTRAL] 5000 after the deductible of 250?
[AGENT][NEUTRAL] No, mhm.
[AGENT][POSITIVE] Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] 50. OK, perfect. Will authorization be required if secondary?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK perfect is there a call reference?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's day if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh, yes, spelling of first name.
[AGENT][NEUTRAL] OK, that's [PII]. And may I have the spelling of yours for my notation?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Is there anything else I can help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] I think that's all I needed. Uh, have they met anything towards that deductible?
[AGENT][NEUTRAL] Um, I can check and see.
[AGENT][NEGATIVE] No, they have not used or met the deductible as of today for [PII].
[CUSTOMER][NEUTRAL] OK, perfect. Alright, and, and you said it was the annual max of, oh, I'm sorry, you said the plan pays up to 5000. OK, got it, alright.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes, for calendar year. Mhm.
[CUSTOMER][POSITIVE] Got it thank you so much I appreciate it.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good week.