AccountId: 011433970860
ContactId: b9f00b78-b268-4187-afb3-73afe5617068
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173250 ms
Total Talk Time (AGENT): 81762 ms
Total Talk Time (CUSTOMER): 41932 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/b9f00b78-b268-4187-afb3-73afe5617068_20250213T13:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I was calling to verify eligibility and benefits for a patient.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 1,446,530, M like Mary, L like Larry, 8.
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. So I am showing that the policy is active. It's been effective since [PII] of, actually, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This particular policy is no longer active, but they do have an active policy. So the policy number that you gave me termed in [PII], it was active from [PII].
[AGENT][NEUTRAL] Their active policy though is 196.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 7205.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, so she's scheduled for an outpatient surgery. It'll be done outpatient hospital.
[AGENT][NEUTRAL] So for outpatients, the policy will pay up to $6000 per calendar year. Did you want me to see if she's used any for the year?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, so she's only used $20 of the balance.
[CUSTOMER][NEUTRAL] OK, and no authorization or anything is needed for this policy, right?
[AGENT][NEUTRAL] Right, no prior offs or pre-certification is required because we're not the major medical insurance company.
[CUSTOMER][POSITIVE] Got it. OK. Thanks for your help.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, that'll be it.
[AGENT][POSITIVE] Alrighty well thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.