AccountId: 011433970860
ContactId: a3d731c3-1b1b-4523-aa66-1a406148c2be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165759 ms
Total Talk Time (AGENT): 84486 ms
Total Talk Time (CUSTOMER): 52399 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/a3d731c3-1b1b-4523-aa66-1a406148c2be_20250314T15:30_UTC.wav
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[AGENT][NEUTRAL] [PII], thank you for calling ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. My name is [PII]. I'm calling from uh South Miami Hospital to verify benefits for a member.
[AGENT][POSITIVE] It would be my pleasure to assist you with those benefits so far. What is a good callback number?
[CUSTOMER][POSITIVE] [PII] is a good callback number.
[AGENT][NEUTRAL] Thank you, [PII]. And the policy number for the patient, please?
[CUSTOMER][NEUTRAL] That would be 0233708 ML 8.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Was there another number at the end that's a little short.
[CUSTOMER][NEUTRAL] Let me see, hold on, I'll tell you right now.
[CUSTOMER][NEUTRAL] Give me 1 2nd, OK, so I have.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] OK, I have 0233708.
[CUSTOMER][NEUTRAL] 2, M for Mike, L for Larry, and then 8 at the end.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, that sounds better. And [PII], I can help you with that eligibility and benefits. What's the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] And [PII], I'm showing that [PII]'s policy is active, effective date on the policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is 51-2023.
[AGENT][NEUTRAL] And this is a secondary policy to his primary insurance policy.
[AGENT][NEUTRAL] Are there specific benefits you're needing?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, just an outpatient, um, surgery benefits. So how much of that, um, yearly does he have and how much has been met?
[AGENT][NEUTRAL] All right. He does have a calendar year max benefit for outpatient services of one surgery of $1000.
[AGENT][NEUTRAL] That is a verification of coverage, not a guarantee of payment, and as of right now, he has the full benefit remaining for 2025.
[AGENT][POSITIVE] Anything else I can help you with? As of right now, as of right now, he's got that full benefit remaining.
[CUSTOMER][NEUTRAL] OK, has he used any of it? Alright.
[CUSTOMER][NEUTRAL] Oh, OK, OK. Can I get a reference number?
[AGENT][NEUTRAL] Reference number would be my name and today's date. I spell my name A L I C I [PII].
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][POSITIVE] OK, thank you very much. OK, you have a nice day.
[AGENT][POSITIVE] Be my pleasure to assist you, [PII]. Thank you for calling APL. Hope you have a wonderful day as well and happy weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.