AccountId: 011433970860
ContactId: c26262b1-dd78-416c-8bfc-14f1d86f7f90
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285920 ms
Total Talk Time (AGENT): 106682 ms
Total Talk Time (CUSTOMER): 85528 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/c26262b1-dd78-416c-8bfc-14f1d86f7f90_20250106T21:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, hi, good afternoon, um.
[CUSTOMER][NEUTRAL] I was calling for benefits and eligibility on a patient.
[AGENT][NEUTRAL] OK, I can help you with this it's an eligibility. Can I get your name and your number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you [PII], what is the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And her policy number please?
[CUSTOMER][NEUTRAL] Uh, the policy number.
[CUSTOMER][NEUTRAL] 0247.
[CUSTOMER][NEUTRAL] 3414.
[CUSTOMER][NEUTRAL] M as in mom. L as in Larry, 8.
[AGENT][POSITIVE] OK, thank you, let me pull that policy in for you real quick.
[AGENT][NEUTRAL] OK, do show that [PII] does have an active policy and her effective date is for [PII].
[AGENT][NEUTRAL] And this is to verify benefits. It's not a guarantee of payment. This is a supplemental insurance policy that is secondary to the primary.
[AGENT][POSITIVE] It helps with deductible, co-pay, or co-insurance.
[AGENT][NEUTRAL] She has an inpatient benefit amount.
[AGENT][NEUTRAL] Of $5000 per confinement.
[AGENT][NEUTRAL] And then she also has an outpatient benefit amount per calendar day of $300.
[CUSTOMER][NEUTRAL] Sorry, can you repeat?
[CUSTOMER][NEUTRAL] You said the $5000 was for what?
[AGENT][NEUTRAL] Per occurrence
[AGENT][NEUTRAL] If she's inpatient.
[CUSTOMER][NEUTRAL] OK, and you said outpatient was 300?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, and that 300 covers her on a daily basis or?
[AGENT][NEUTRAL] Yes, per calendar day.
[CUSTOMER][NEUTRAL] OK, now when it comes to the deductible for her primary insurance, do you guys cover that?
[AGENT][NEUTRAL] If she's an inpatient in the hospital more than 18 hours, the $5000 will help with the deductible, co-pay or co-insurance.
[AGENT][NEUTRAL] And our outpatient calendar day benefit um also helps with deductible copay or co-insurance.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, um, can I get a reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name. It's 40 and they state.
[CUSTOMER][NEUTRAL] I'm sorry my line keeps coming in and out I can't catch the numbers.
[AGENT][NEUTRAL] Um, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Um, I didn't catch what you said before today's date.
[AGENT][NEUTRAL] My name, [PII].
[CUSTOMER][NEUTRAL] [PII] sorry.
[AGENT][NEUTRAL] [PII] yes.
[CUSTOMER][NEUTRAL] [PII] in today's day, OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome you have a wonderful day and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye bye.