AccountId: 011433970860
ContactId: b9e792e4-b6c1-4e4f-9268-2edfbeb0824b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170839 ms
Total Talk Time (AGENT): 77384 ms
Total Talk Time (CUSTOMER): 60163 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/b9e792e4-b6c1-4e4f-9268-2edfbeb0824b_20250418T18:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, yes, Ms. [PII], I'm calling to verify benefits and eligibility for a patient that was seen in our ER on [PII].
[AGENT][POSITIVE] OK, I am happy to check benefits and eligibility. Do you have their policy number?
[CUSTOMER][NEUTRAL] Uh, the member ID number that I have is 02595136.
[AGENT][POSITIVE] All right, thank you for that.
[AGENT][NEUTRAL] And can I grab your first name?
[CUSTOMER][NEUTRAL] Uh yes ma'am. My first name is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Uh, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient's name we have Ms. [PII]. Uh, date of birth is [PII].
[AGENT][POSITIVE] All right, thank you for that. So patient is active. I'm showing the effective date on here is [PII].
[CUSTOMER][NEUTRAL] Alrighty, and uh let's see, does she have any co-insurances or copays for any emergency uh visit benefits?
[AGENT][NEUTRAL] Uh, so there's not gonna be any co-pay co-insurance. This is a limited benefit plan, so it pays just a set amount depending upon what they're being seen for.
[AGENT][NEUTRAL] Um, it was an ER visit, you said?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Were they admitted to the hospital at any point?
[CUSTOMER][NEUTRAL] Uh, no, ma'am. They left same day.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so under this patient's plan, the outpatient accident and sickness is for emergency room, it pays $50 per day and it's a maximum of 2 calendar days per covered person.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] And let's see, would you happen to have a reference number for our call for today?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial and then today's date. So my name again is [PII], that's [PII], and then today's date.
[CUSTOMER][POSITIVE] Alrighty, well I thank you so very much for assisting me with that information and I hope you have a great weekend and happy [PII].
[AGENT][POSITIVE] You too. You too. Bye-bye.
[CUSTOMER][POSITIVE] Thank you