AccountId: 011433970860
ContactId: c1e9b551-2d54-4ee8-a85f-8f87ee580fb1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200410 ms
Total Talk Time (AGENT): 80058 ms
Total Talk Time (CUSTOMER): 98516 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/c1e9b551-2d54-4ee8-a85f-8f87ee580fb1_20250430T15:30_UTC.wav
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[CUSTOMER][POSITIVE] Good bye
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], my name is [PII], and I'm calling from Saint Lucie Medical Center.
[CUSTOMER][NEUTRAL] Um, I would like to verify eligibility for one of our patients.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] What you gave to me is 023 04196 ML 7.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII], [PII].
[CUSTOMER][NEUTRAL] Please don't mind the live music in the bath.
[CUSTOMER][NEUTRAL] It's so crazy.
[CUSTOMER][NEUTRAL] She's crazy.
[AGENT][POSITIVE] Beautiful.
[CUSTOMER][POSITIVE] Yeah, it is beautiful.
[AGENT][NEUTRAL] Um, uh, what were you needing eligibility?
[CUSTOMER][POSITIVE] She's just wonderful.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, looks like she's effective [PII], and she's currently active.
[CUSTOMER][NEUTRAL] [PII]. What about, um, she mentioned to me that she has a $1500 limit.
[AGENT][NEUTRAL] Uh, let me pull up her phone.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] Is this gonna be for like out outpatient services or what type of services?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yeah, she's coming outpatient surgery tomorrow.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, not a guarantee of payment basic outline of the policy. Let me pull that up. Give me one moment.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Uh, yes, she has a $1500 per covered person per calendar year benefit. And this is a secondary policy. So after primary insurance pays or processes the claim, this potentially picks up any deductible and co-insurance.
[CUSTOMER][NEUTRAL] So her deductible with the hospital is $2000.
[AGENT][NEUTRAL] Um, so this would.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Like once her primary insurance processes the claim, if $2000 was applied towards the deductible for hospital services, this would pay a max of $1500 per calendar year.
[CUSTOMER][NEUTRAL] Oh, so once claims are processed, then she would be the, I mean then this.
[CUSTOMER][NEUTRAL] would cover up to 1500.
[AGENT][NEUTRAL] Correct, and then
[CUSTOMER][NEUTRAL] She has a different understanding.
[AGENT][NEUTRAL] Yeah, so when you file the claim, be sure and file with that primary EOB, um, and then like I said, we'll pay up to $1500 so.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, uh huh.
[CUSTOMER][NEUTRAL] 1500. May I ask for a reference to this call?
[AGENT][NEUTRAL] Yes, it's my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] Mhm. Awesome. Thanks so much, [PII]. Enjoy the rest of your shift.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you do too.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] You thanks take care bye.