AccountId: 011433970860
ContactId: a3932905-65bc-48bc-8df8-82d2e9cbd126
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191949 ms
Total Talk Time (AGENT): 83114 ms
Total Talk Time (CUSTOMER): 64749 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/a3932905-65bc-48bc-8df8-82d2e9cbd126_20250327T22:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I work with WakeMed and I have a patient here who I would like to get eligibility for for medical uh treatment.
[AGENT][NEUTRAL] OK. Happy to check on the eligibility today, [PII]. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have the uh uh employee ID. I've got the card in front of me if that.
[CUSTOMER][POSITIVE] We'll help you.
[AGENT][NEUTRAL] OK, does it have any sort of like member certificate number, anything like that on it?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just got employee ID is all it's got on here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that starts with like a D like David.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh-huh, yes.
[AGENT][NEUTRAL] Yeah, I can't pull them with that number. I can check by their name or social. Do you have?
[CUSTOMER][NEUTRAL] I have the name.
[AGENT][NEUTRAL] OK, what's the last name.
[CUSTOMER][NEUTRAL] For you, OK, um, I'll spell for you [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And it's [PII].
[CUSTOMER][NEUTRAL] That's the first name.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and then what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] All right, thank you so much. So the patient does have an active plan with us. The effective date is [PII]. Do you want to take down this policy number?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] The policy number is 02594444.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And patients just coming in for like an office visit, is that what you need the benefits for?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, for me, yeah, for medication.
[CUSTOMER][NEUTRAL] Run a primary office setting.
[CUSTOMER][NEUTRAL] It's what we bill.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the patient's plan is like a limited benefit plan, hospital indemnity. It's only gonna pay a set amount depending upon what they're being seen for.
[AGENT][NEUTRAL] Uh, patient's plan has benefits for just hospital admission, confinement, and surgery with diagnostic testing. I don't see any other benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I need to probably collect ahead of time then.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I don't see any benefits for like office visits or anything.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Did you need me to check anything else, [PII]?
[CUSTOMER][POSITIVE] No, I appreciate your help.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] You as well thank you bye bye now.
[AGENT][NEUTRAL] Bye-bye.