AccountId: 011433970860
ContactId: ad05ea37-9f00-4a76-91b9-e67f3162f342
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243009 ms
Total Talk Time (AGENT): 100932 ms
Total Talk Time (CUSTOMER): 107835 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/ad05ea37-9f00-4a76-91b9-e67f3162f342_20250131T18:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Mount Sinai Medical Center.
[CUSTOMER][NEUTRAL] I just want to verify the coverage of one of our patients with this insurance.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits [PII]. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's going to be [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name?
[CUSTOMER][NEUTRAL] The patient's name is going to be [PII] and [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Or getting any cold [PII].
[CUSTOMER][NEUTRAL] Yes, it is um [PII].
[AGENT][NEUTRAL] Thank you. And what's [PII]'s policy number?
[CUSTOMER][NEUTRAL] OK, that's.
[CUSTOMER][POSITIVE] Interesting question.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is it the same the same one as the subscriber ID?
[AGENT][NEUTRAL] It it might say uh inpatient or outpatient cert number 2.
[AGENT][NEUTRAL] You wanna give me the subscriber ID and let me try that first?
[CUSTOMER][NEUTRAL] Yeah, let's try that one. I have 02321251.
[AGENT][POSITIVE] OK, that looks like a good number. Let me try that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] That's a good number. I've got it pulled up.
[CUSTOMER][POSITIVE] Uh thank [PII] yeah.
[CUSTOMER][NEUTRAL] I've been trying to verify this like 2 hours ago, OK, so yeah, I know, I know, I know.
[AGENT][NEUTRAL] 00 my.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I just had, I just want to know the to verify the coverage I know this is a supplemental plan that she has with you guys.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, so yeah, tell me.
[AGENT][NEUTRAL] OK, so her effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify her coverage. It's not a guarantee of payment. You're correct, this is a supplemental insurance policy. It's a gap insurance that helps with deductible, co-pay, and co-insurance only. Um, she has an inpatient benefit amount of $2000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then she also has an out.
[CUSTOMER][NEUTRAL] 3000 you said?
[AGENT][NEUTRAL] 2000.
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] And then she also has an outpatient calendar year benefit amount of $1000.
[CUSTOMER][NEUTRAL] OK, um, do we have any, um, how much is the coinsurance for the outpatient hospital outpatient?
[AGENT][NEUTRAL] She doesn't have co-insurance. It, this policy helps with deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what's the deductible?
[AGENT][NEUTRAL] There is no deductible.
[AGENT][NEUTRAL] The only deductible she has is for ER and that's $300.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the outpatient you said is 1000 right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Effective day [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, can I have a reference call number?
[AGENT][NEUTRAL] Yes, you can use my name. It's [PII].
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] OK, [PII] at the end?
[AGENT][NEUTRAL] Why?
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Uh, mm.
[CUSTOMER][POSITIVE] Very good.
[CUSTOMER][POSITIVE] Alright [PII], I thank you so much for your help, right?
[AGENT][POSITIVE] You're very welcome. You have a good weekend. Thanks for calling APL.
[CUSTOMER][NEUTRAL] OK, that will be it.
[CUSTOMER][POSITIVE] You too thank you enjoy your weekend bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Bye.