AccountId: 011433970860
ContactId: b2d4121f-4327-4f22-931f-2b31f6585bc0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214190 ms
Total Talk Time (AGENT): 117660 ms
Total Talk Time (CUSTOMER): 74768 ms
Interruptions: 3
Overall Sentiment: AGENT=1.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/b2d4121f-4327-4f22-931f-2b31f6585bc0_20250603T19:51_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is [PII] and I'm calling from [PII], and I am trying to verify eligibility and benefits on a member.
[AGENT][POSITIVE] OK, I'll be glad to help you, [PII]. Go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] That is 017.
[CUSTOMER][NEUTRAL] 49315
[AGENT][NEUTRAL] Alrighty, [PII], thank you for that information. Now, while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Alrighty, thank you for all the
[AGENT][NEUTRAL] The information sent to you. Now, your patient's name and date of birth today.
[CUSTOMER][NEUTRAL] Uh, it is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] Alrighty, thank you so much for all that information, [PII]. Looks like [PII] is a dependent spouse on this medical supplemental plan. I do show her original effective date. It's [PII]. She is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am, it's for maternity.
[AGENT][NEUTRAL] OK, inpatient or outpatient?
[CUSTOMER][NEUTRAL] For inpatient.
[AGENT][NEUTRAL] Alrighty, let me get that benefit pack pulled up. Let's see. OK, now, of course, what we are, [PII], is just her medical supplemental plan. So the only thing we will pick up and pay on is anything that is applied towards the patient's deductible, co-pay or co-insurance at her primary insurance carrier for sickness and injury only. Now for her inpatient benefit here at APL, there's no pre-search.
[CUSTOMER][NEUTRAL] Why
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No deductible. She has a $7900 benefit payable per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right, and um, are you able to tell me if the, if the child, the newborn will be covered under the policy even if uh they're not added?
[AGENT][NEUTRAL] They have to add the baby, uh, they have 30 days to add the baby, but the insured already has dependent coverage, all they got to do is add the baby.
[CUSTOMER][NEUTRAL] And you said no authorization is required.
[AGENT][POSITIVE] That is correct. Yes, ma'am. Is there anything else that I can help answer for you today, [PII]?
[CUSTOMER][NEUTRAL] Uh no, ma'am. I just needed to get your name again, the first initial to your last name and the call reference number please.
[AGENT][NEUTRAL] Alrighty, we don't give a call reference number, [PII], but you can use my name in today's date and my name is [PII] and that is spelled [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] All right, thank you so much. I really appreciate it.
[AGENT][NEUTRAL] Well,
[AGENT][POSITIVE] Yes, ma'am, [PII], and thanks for calling APL. You have a great rest of your day, OK?
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.