AccountId: 011433970860
ContactId: af108a4e-a699-4304-be9c-ed54482346c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192899 ms
Total Talk Time (AGENT): 83511 ms
Total Talk Time (CUSTOMER): 57731 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/af108a4e-a699-4304-be9c-ed54482346c2_20250122T18:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII]. First initial of my last name [PII]. I'm calling from a provider facility because I need to verify eligibility and benefits for a member, please.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits, Miss [PII]. What is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you and what's the patient's name?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] And the, um,
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then what is his policy number, please?
[CUSTOMER][NEUTRAL] It's 1341924, M as in Mike, L as in Lima, and the number 8.
[AGENT][POSITIVE] OK, thank you. I'm gonna pull that policy in for us real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy.
[AGENT][NEUTRAL] His effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify his coverage. It's not a guarantee of payment. He has a supplemental insurance policy that is billed secondary to the primary.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It helps with deductible, co-pay, and co-insurance. He has an inpatient benefit amount per calendar year of $6000 and then he also has an outpatient benefit amount per calendar year of $6000.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And are you able to see if it's used any of those $6000?
[AGENT][NEUTRAL] Uh, yes, let me look real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Nothing has been used for the year of [PII] on this policy.
[CUSTOMER][POSITIVE] Oh, OK, perfect. So the full amount remains available. All right, perfect. Thank you so much. That's all I needed to know. Uh, by any chance, do you provide reference numbers for your call?
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much I hope you have a great rest of your day.
[AGENT][POSITIVE] You too thank you so much Ms. [PII] you have a blessed one thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye.