AccountId: 011433970860
ContactId: a55bb069-ae9b-414d-8e58-3aecc997dcef
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207440 ms
Total Talk Time (AGENT): 99725 ms
Total Talk Time (CUSTOMER): 86540 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/a55bb069-ae9b-414d-8e58-3aecc997dcef_20250513T18:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ACL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Mount Sinai Medical Center. I'm calling to verify a patient's eligibility.
[AGENT][NEUTRAL] OK, I can help you with eligibility, Ms. [PII]. May I please get your callback number, ma'am, just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] I'm [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] His policy number is 02598409.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][POSITIVE] All right, I do show that [PII] does have an active policy with us. The effective date of the policy is [PII] and the policy is current.
[CUSTOMER][NEUTRAL] OK, what type of plan is it? The coverage should I say?
[AGENT][NEUTRAL] And this
[AGENT][NEUTRAL] Yes, ma'am. This is just to verify benefits. It's not a guarantee of payment. He has a supplemental insurance policy that's billed secondary to the primary, and it helps with deductible, co-pay and co-insurance. He has an inpatient calendar year benefit amount of $2500 and then he also has an outpatient calendar year benefit amount of $1250.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy and authorization is that required or no?
[AGENT][NEUTRAL] No, ma'am. Uh, it will not be required because it's not the major medical insurance.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Alright, and the member ID I gave you, is that the current member ID?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, because I remember before there was to be letters at the end and I guess notification was out that they're gonna switch it so it's without the letters now so that's why I wanna know if that's the current one.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am, that is current.
[AGENT][NEUTRAL] And just for your own information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] those letters that we had the ML7 or the ML8 ML 7 is uh inpatient ML8 is outpatient, so that still has the same um policy number just without the letter.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, was outpatient, yep.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Alright, thank you for clarifying that for me. Thank you very much, [PII], um, that's all I need. That's the only patient I needed.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Have a great one, OK?
[AGENT][NEUTRAL] OK, Ms. [PII].
[AGENT][POSITIVE] You too you have a great day and thank you for calling NPL.
[CUSTOMER][NEUTRAL] All right, bye now.
[AGENT][NEUTRAL] Bye-bye.