AccountId: 011433970860
ContactId: 9d30a822-2b88-4842-9b88-34b62f3b140b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422040 ms
Total Talk Time (AGENT): 164929 ms
Total Talk Time (CUSTOMER): 171860 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/9d30a822-2b88-4842-9b88-34b62f3b140b_20250214T17:45_UTC.wav
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[CUSTOMER][NEUTRAL] Wait, do we get paid overtime? No. Hi, how are you?
[AGENT][NEUTRAL] calling APL.
[AGENT][POSITIVE] Good.
[CUSTOMER][NEUTRAL] Sorry, the call got cut off. I didn't, I didn't hear the what you said in the beginning, sorry.
[AGENT][NEUTRAL] My name is [PII] and I'm with APL.
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling to verify um a policy.
[AGENT][NEUTRAL] OK, I can help you with eligibility and can you repeat your name for me please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you [PII], what is your um callback number just in case call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And her policy number, please?
[CUSTOMER][NEUTRAL] 01723470 ML8
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[AGENT][NEUTRAL] OK, I do show that this policy for [PII] is lapsed. It's no longer active, effective [PII].
[AGENT][NEUTRAL] Let me check. I'm checking to see if she has anything. She does have an active policy. Let me see if she's on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, she has a um policy that is active. The policy number is 233.
[AGENT][NEUTRAL] 7118 and it's effective [PII].
[CUSTOMER][NEUTRAL] Wait, that's the full policy number?
[AGENT][NEUTRAL] Yes, 23
[CUSTOMER][NEUTRAL] 2337.
[AGENT][NEUTRAL] 233-7118
[CUSTOMER][NEUTRAL] Sorry
[CUSTOMER][NEUTRAL] 233-7118 OK with and with APL, right? I mean obviously.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Um, can I have the, the benefits for emergency services?
[AGENT][NEUTRAL] Oh, yes ma'am. Um, this is just to verify her coverage. It's not a guarantee of payment. This is a supplemental policy. It's a gap insurance that's billed secondary to the primary and it does help with um
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Deductible, co-pay, and co-insurance?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see what she has for ER.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She has um hm.
[AGENT][NEUTRAL] Outpatient benefit amount of $1000.
[AGENT][NEUTRAL] But she also has an ER deductible of $500.
[CUSTOMER][NEUTRAL] An ER deductible, so she has to.
[CUSTOMER][NEUTRAL] What does that mean?
[AGENT][NEUTRAL] She has a deductible of $500 for the emergency room?
[AGENT][NEUTRAL] After that $500 is met for the emergency room, the policy will pay up to $1000 per calendar year.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] So she has to pay the 500 before the policy pays.
[CUSTOMER][NEUTRAL] How much again?
[AGENT][NEUTRAL] The policy pays up to $1000 per calendar year.
[CUSTOMER][NEUTRAL] Registration that used to be.
[CUSTOMER][NEUTRAL] $1000 per calendar year.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So how would that, OK, so how would that, um, if she has a, if the primary has a, let's say an ER co-pay, she would have to pay the ER copay of the primary and the $500 deductible?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, she, she would have to pay the ER uh.
[AGENT][NEUTRAL] Deductible up to $500.
[CUSTOMER][NEUTRAL] Oh, will go to her, OK, got it. And that will go toward her deductible with you guys?
[AGENT][NEUTRAL] Right, and then the primary insurance sends in their portion.
[CUSTOMER][NEUTRAL] Hey [PII], is this all?
[AGENT][NEUTRAL] And then she has an outpatient calendar year benefit amount of $1000.
[CUSTOMER][NEUTRAL] Mhm. Mm.
[CUSTOMER][NEUTRAL] OK, yeah, but we're not outpatients so.
[AGENT][NEUTRAL] OK, she also has an inpatient benefit amount?
[AGENT][NEUTRAL] Of
[CUSTOMER][NEUTRAL] And that deductible hasn't been met yet, right?
[AGENT][NEUTRAL] $4000.
[AGENT][NEUTRAL] Let me check for you real quick.
[CUSTOMER][NEUTRAL] For the ER services.
[AGENT][NEUTRAL] Right, let me look at the policy and see for you real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And I said but I got here in my hand.
[CUSTOMER][NEGATIVE] Oh wow, no, mommy, no thank you.
[CUSTOMER][NEUTRAL] A pre no so and and the mental nesto.
[AGENT][NEUTRAL] No, ma'am, nothing has been met for the year of [PII].
[CUSTOMER][NEUTRAL] So in this case she would be she would be financially responsible for her primary anything that the primary has correct for this visit?
[AGENT][NEUTRAL] For ER
[CUSTOMER][NEUTRAL] From my understanding.
[CUSTOMER][NEUTRAL] For ER, yes, for ER, OK.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can I have a reference number for the call?
[AGENT][NEUTRAL] Yes, you can um use my name [PII] in today's date.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh my apologies. Do you have a, can I have your, the initials of your last name, sorry?
[AGENT][NEUTRAL] Yes, ma'am. It's A.
[CUSTOMER][POSITIVE] Thank you so much have a great day.
[AGENT][NEUTRAL] OK, Ms. [PII], one quick question, what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You have a good day too, and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][NEUTRAL] Bye-bye.