AccountId: 011433970860
ContactId: af220cb1-7b7a-40a6-9acb-cbdf03ba3ff3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167210 ms
Total Talk Time (AGENT): 83943 ms
Total Talk Time (CUSTOMER): 59998 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/af220cb1-7b7a-40a6-9acb-cbdf03ba3ff3_20250304T15:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. I'm calling from Online and Medical. We facility in [PII]. I need to verify benefits for outpatient hospital services, please.
[AGENT][NEUTRAL] OK, I can help with that, [PII], thank you. May I have your callback number if disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. What is that policy number, please, [PII]?
[CUSTOMER][NEUTRAL] 1484339
[AGENT][POSITIVE] OK, I have that as 1484339. Thank you.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Calling for Mr. [PII] [PII].
[AGENT][NEUTRAL] Thank you, and you're calling for eligibility, um, do you need benefits as well or just eligibility?
[CUSTOMER][NEUTRAL] Uh, coverage, uh, benefits for outpatient hospital.
[AGENT][NEUTRAL] OK, um, this policy actually has term termed as of [PII]. Give me one moment please, [PII], to check for an active policy for the member and I get the information to you. Thank you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, the policy number is 2123561.
[CUSTOMER][NEUTRAL] 212-3561
[AGENT][NEUTRAL] Yes, with an effective date of [PII] and shows active and for outpatient benefits for [PII], one moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Please note verification of benefits provided does not guarantee payment. The outpatient max for the calendar year is $6650. There is a deductible of $500 for the year.
[CUSTOMER][NEUTRAL] 6650 you said 6650?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And this is calendar year and a $500 deductible.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] Alrighty then, so I guess I got everything I need. Oh wait, one more thing. Would you be able to tell me if anything has been applied towards the um use of outpatient coverage please?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Of course one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. I'm currently the member has only met $150 towards a $500 deductible, and of course no benefits have been used.
[CUSTOMER][NEUTRAL] 150 so where's the 500.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Got it. 3:50 left. Appreciate it, [PII]. thank you so much. I think I got everything I needed.
[AGENT][POSITIVE] You're welcome, [PII] and thank you so much for calling APL. You have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye.