AccountId: 011433970860
ContactId: 9ae1b7ce-646c-4178-9642-d13f12333754
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330950 ms
Total Talk Time (AGENT): 126434 ms
Total Talk Time (CUSTOMER): 101053 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/9ae1b7ce-646c-4178-9642-d13f12333754_20250403T17:37_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm with Ascension Saint Jean Medical Center in [PII]. I was hoping to try and verify eligibility for a patient we had in our ER yesterday.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the eligibility and [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Uh, good phone number would be [PII].
[CUSTOMER][NEUTRAL] And the policy number is 019.
[CUSTOMER][NEUTRAL] 05622.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII] [PII].
[AGENT][NEUTRAL] And the policy number was 101905622?
[CUSTOMER][NEUTRAL] Uh yes ma'am, that's what is loaded in.
[AGENT][NEUTRAL] The only reason I'm asking is because it's pulling up a different member, it's a completely different name and date of birth. Um.
[CUSTOMER][POSITIVE] Good
[AGENT][NEUTRAL] What's the member's first and last name?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Their their name is [PII].
[AGENT][NEUTRAL] What's the, is there another like a subscriber name or he is the subscriber?
[CUSTOMER][NEUTRAL] Uh, it shows the insured name is [PII]. Um, let me look on, hold on, let me look on the.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Scan of the insurance card from yesterday.
[CUSTOMER][NEGATIVE] Oh, that's not even from yesterday. They didn't even get anything, man.
[AGENT][NEUTRAL] And is it [PII]?
[CUSTOMER][NEUTRAL] Oh, [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I don't know what's going on with that.
[CUSTOMER][NEUTRAL] It's a little weird, but mm.
[AGENT][NEUTRAL] OK, so I believe I just located and it's medical, right?
[AGENT][NEUTRAL] Oh you said ER, yes, hold on one second.
[CUSTOMER][NEUTRAL] Uh yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This might be it.
[AGENT][NEUTRAL] And can you repeat that date of birth?
[CUSTOMER][NEUTRAL] It is listed as [PII].
[AGENT][NEUTRAL] OK, this is it. And thank you for verifying and all the information provided is a verification of benefits, not a guarantee of payment. So, um, the last number is a 5, 1905625.
[CUSTOMER][NEUTRAL] 00, OK.
[CUSTOMER][POSITIVE] Thank you, go ahead and get that really quick.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And then let me see for.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] The deductible.
[AGENT][NEUTRAL] OK, so the calendar year max is $4500 for outpatient expenses um due to accident and sickness. There is a $500 deductible unless it's the emergency room where there is no deductible for that, um, but the calendar year max is $4500. Did you want me to see if any has been used for [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, if you don't mind, I'll see if you.
[AGENT][NEUTRAL] OK. So I'm not showing any of the benefits have been used for [PII].
[CUSTOMER][NEUTRAL] OK, and do you have uh an active date?
[AGENT][NEUTRAL] Um, let me see, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] This policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And um does it oh never mind I have the group number is 13543, is that correct?
[AGENT][NEUTRAL] Um, hold on one second.
[AGENT][NEUTRAL] Yes, 13543.
[CUSTOMER][POSITIVE] Oh perfect OK.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Um, if you can provide me with a reference number, I think we're all good.
[AGENT][NEUTRAL] All right, so there's no call reference number, but you can use my name in today's date. And again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you very much, [PII] you have a great day.
[AGENT][POSITIVE] You're welcome. You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] All right, bye-bye.