AccountId: 011433970860
ContactId: a2033a1d-22cd-41b8-9b9e-07cf59a19da2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224880 ms
Total Talk Time (AGENT): 133360 ms
Total Talk Time (CUSTOMER): 62379 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/a2033a1d-22cd-41b8-9b9e-07cf59a19da2_20250416T14:50_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning. Um, my name is [PII]. I'm from Jackson Memorial Hospital, and I am calling to check, uh, benefits, please, on the patient.
[AGENT][POSITIVE] Yes, ma'am. [PII], I will be glad to help you. Go ahead and give me a good policy number, please, ma'am.
[CUSTOMER][NEUTRAL] Yes, it is um
[CUSTOMER][NEUTRAL] 02301189 M as in Mary L as in Larry.
[CUSTOMER][NEUTRAL] Number 8.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for all of that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Alrighty, [PII], thank you for all that information. Now your patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], um, date of birth, it's [PII].
[AGENT][NEUTRAL] Alright, I think I put the wrong policy number in. Give me that policy number one more time, please, ma'am.
[CUSTOMER][NEUTRAL] Yes, 02301189 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK, I see it now. OK, [PII], thank you so much for all that information. Now you did say [PII] was the patient, and I do show her original effective date is [PII]. She is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want some type of benefit, [PII], is that correct?
[CUSTOMER][POSITIVE] Yes, outpatient hospital benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Outpatient hospital. All right, let me get over there and let's see what her benefits are. Now, of course, while we are, it's just her medical supplemental plan. So the only thing that we would pick up and pay on is anything for sickness and injury that is applied towards her deductible, co-pay, or co-insurance at her primary insurance carrier. Nothing routine he was.
[AGENT][NEUTRAL] Covered no matter what. Now her outpatient benefit here is going to be a zero deductible, no pre-cert, and she has a $2500 benefit payable per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Has she met her, um, the calendar year amount?
[AGENT][NEUTRAL] Let's see what she's used.
[AGENT][NEUTRAL] Looks like as of today, she has used $977.16 of her max benefit as of today.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. OK. And you said no pressure required, right?
[AGENT][NEUTRAL] OK. Well, is that all that I can help you with?
[AGENT][POSITIVE] Correct, no pre yes ma'am.
[CUSTOMER][NEUTRAL] Yes, may I please have your name, please?
[AGENT][NEUTRAL] Yes, ma'am. [PII], is that all I can help you with today?
[CUSTOMER][NEUTRAL] Yes, may I please have your name for reference, please?
[AGENT][NEUTRAL] Yes, ma'am. Um my name is [PII], that is spelled [PII] and we don't give reference numbers, [PII], but you can use my name in today's date if you need to do so, OK?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Oh, yes, ma'am, and thank you [PII] for calling APO. You have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.