AccountId: 011433970860
ContactId: a6a96c61-caa4-4f06-9613-4de6043a0227
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189589 ms
Total Talk Time (AGENT): 98171 ms
Total Talk Time (CUSTOMER): 60623 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/a6a96c61-caa4-4f06-9613-4de6043a0227_20250506T13:26_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hi, yes, I wanna see patients benefits, please.
[AGENT][POSITIVE] OK, I can help you with the benefits. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII], and the contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Her policy number is 02446366ML8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I'm actually showing this particular policy is no longer active. It was effective from [PII], but there is an active policy um as of [PII], and that's 2581438.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sorry, sorry, 2581438?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's the whole policy number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK perfect and can I have the benefits to that one then?
[AGENT][NEUTRAL] Sure, and for outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, outpatient.
[AGENT][NEUTRAL] Alright, the policy for outpatient will pay up to $250 per calendar day.
[CUSTOMER][NEUTRAL] OK, and the yearly?
[AGENT][NEUTRAL] This is not yearly, it's per day.
[CUSTOMER][NEUTRAL] Per day. OK, what about for like for a maternity code that I have?
[AGENT][NEUTRAL] So her policy is broken down into inpatient and outpatient. Um, if she's admitted into the hospital, um, it would go into inpatient and that is $3000 per calendar year.
[CUSTOMER][POSITIVE] OK, perfect. And for the whole maternity care outside of the hospital?
[CUSTOMER][NEUTRAL] Like, does it cover her deductible, does it cover out of pocket? Does it cover her co-pay for in office?
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] OK, so this is her secondary insurance. So yes, we apply to the co-pay, deductible and co-insurance. If it's an outpatient.
[AGENT][NEUTRAL] Service, then it will use the outpatient benefits, so she has the $250 per day max. If it's something that she's admitted for for inpatient, she has the $3000 max.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect and then can I have a reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK perfect thank you so much [PII] have a good day.
[AGENT][NEUTRAL] You asked [PII], was there anything else I can help with?
[CUSTOMER][POSITIVE] Awesome.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye bye.
[CUSTOMER][POSITIVE] Thank you bye.