AccountId: 011433970860
ContactId: b1e94875-e5e0-4e20-8d2e-08a24b165895
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178089 ms
Total Talk Time (AGENT): 82266 ms
Total Talk Time (CUSTOMER): 65609 ms
Interruptions: 0
Overall Sentiment: AGENT=3, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/b1e94875-e5e0-4e20-8d2e-08a24b165895_20250128T18:52_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII]. I'm calling from Nicholas Children's Hospital. I was calling to see if I can get um benefits and eligibility for a patient.
[AGENT][POSITIVE] Oh yeah, I'd love to help you with eligibility and benefits today, Ms. [PII]. And so sorry, one second, what's a great callback number for you?
[CUSTOMER][NEUTRAL] [PII] and that's a direct number?
[AGENT][POSITIVE] Perfect. And the member's policy number?
[CUSTOMER][NEUTRAL] It is 024967887.
[AGENT][POSITIVE] Wonderful, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Give me just a second to get all that pulled up for you.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][POSITIVE] Perfect, I appreciate your patience with that and if you wouldn't mind verifying for me your patient's first and last name and date of birth.
[CUSTOMER][NEUTRAL] Sure, [PII], [PII].
[AGENT][NEUTRAL] All right, I do see [PII] here. He is current and active with an effective date of [PII].
[AGENT][POSITIVE] And you said you're looking for uh I cannot talk. I'm so sorry for benefits, correct?
[CUSTOMER][NEUTRAL] Yes, for um urgent care services.
[AGENT][NEUTRAL] OK perfect so this is gonna fall under our outpatient benefits and while that's loading, I do wanna let you know that any benefit information we give over the phone is just a verification of coverage and not a guarantee of payment.
[AGENT][NEUTRAL] Um, it looks like [PII] has, let me see.
[AGENT][NEUTRAL] An outpatient benefit max of $4000 per calendar year.
[CUSTOMER][NEUTRAL] OK, does that include X-ray?
[AGENT][NEUTRAL] Um, it does look like he has diagnostics listed as part of his, uh, policy.
[CUSTOMER][POSITIVE] OK, diagnostic too, OK, perfect.
[CUSTOMER][NEUTRAL] OK, so it pays $4000 up to $4000 a year?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] A year. OK, great, give me one second.
[AGENT][POSITIVE] No worries.
[CUSTOMER][POSITIVE] OK, 77. OK, great.
[CUSTOMER][NEUTRAL] OK, I'm sorry you said your name was?
[AGENT][NEUTRAL] Yes, it's [PII], [PII], last [PII], [PII].
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] How do you thank you is there a call reference number?
[AGENT][NEUTRAL] Oh yeah, it's just my name and today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help today I really appreciate it.
[AGENT][POSITIVE] Hey, it's my pleasure, [PII]. Thank you for calling APL and you have such a fabulous day.
[CUSTOMER][POSITIVE] Thank you honey you too thanks bye bye.
[AGENT][POSITIVE] Thanks bye bye.