AccountId: 011433970860
ContactId: 9f268a10-c987-461b-9091-910c98bd438b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170029 ms
Total Talk Time (AGENT): 90439 ms
Total Talk Time (CUSTOMER): 40950 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/9f268a10-c987-461b-9091-910c98bd438b_20250113T21:08_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from Prisma Health, and I want to verify business benefits eligibility.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with some eligibility and benefits today and did you say your name was [PII]?
[CUSTOMER][NEUTRAL] [PII], spelled [PII]
[AGENT][POSITIVE] Oh, perfect. Thank you, Ms. [PII]. And what is a good callback number?
[CUSTOMER][NEUTRAL] Uh, it's [PII]. No extension.
[AGENT][POSITIVE] Perfect. Thank you. And the policy number for your patient?
[CUSTOMER][NEUTRAL] It's uh 246-547-4.
[AGENT][NEUTRAL] Um, give me a moment to get that pulled on up for you, my friend.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And would you be able to verify for me please your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, your patient is current and active. It looks like their effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And as far as benefit goes, are you needing inpatient or outpatient?
[CUSTOMER][NEUTRAL] Inpatient or sick visit for primary and specialist?
[AGENT][NEUTRAL] You said inpatient and then sick visit for primary and specialist?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I'm getting that benefit information pulled up for you right now. I do wanna let you know that any benefits I give over the phone is gonna be a verification of coverage and not a guarantee of payment. Um, their office visits, whether specialists or um otherwise fall under their outpatient benefits, um, and it looks like their outpatient benefits and their inpatient benefits are combined for calendar year of $2000.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So no co-pay or anything?
[AGENT][NEUTRAL] Is there any other benefit of
[AGENT][NEUTRAL] No, we're their secondary insurance, so we're their supplemental.
[CUSTOMER][NEUTRAL] OK. I just need your name and call reference number, please.
[AGENT][NEUTRAL] Oh yeah, you betcha. My name is [PII], first initial, last name, [PII], and then today's date, uh, I'm so sorry, I cannot talk. The call reference is my name and today's date and
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] My pleasure you have such a wonderful day.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] Thank you too.
[AGENT][NEUTRAL] Bye-bye.