AccountId: 011433970860
ContactId: c2b26bef-541b-4229-9161-883c36d2e13f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 133940 ms
Total Talk Time (AGENT): 86581 ms
Total Talk Time (CUSTOMER): 28310 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/c2b26bef-541b-4229-9161-883c36d2e13f_20250521T20:17_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] OK, um, hi, I'm calling to verify outpatient hospital benefits for the facility.
[AGENT][POSITIVE] OK, I'd be glad to help you. go and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] All right, [PII], thank you for that. Now, the patient's policy number.
[CUSTOMER][NEUTRAL] 02141739 ML 7.
[AGENT][NEUTRAL] Alrighty, [PII], thank you so much for that information. Let's see. I'm getting this pulled up. OK, what's your patient's name and date of birth today, please, ma'am?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Alright, [PII], thanks for all that information. Looks like [PII] is the insured on this medical supplemental plan does show the original effective date as [PII] current policy is 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, [PII]?
[CUSTOMER][NEUTRAL] For outpatient hospital.
[AGENT][NEUTRAL] All right, let's see. Now, of course, what we are trying to is just the medical supplemental plan, so the only thing that we will pick up and pay on is anything that is applied towards the patient's deductible, co-pay, or co-insurance at the primary insurance carrier for sickness and injury only. Nothing routine here is covered no matter what, [PII].
[AGENT][NEUTRAL] And their outpatient benefit here is gonna be no pre-cert, zero deductible, and they have a $500 benefit payable per calendar day.
[CUSTOMER][NEUTRAL] OK, what was your name again?
[AGENT][NEUTRAL] My name is [PII] spelled [PII] And is that all that I can help answer for you today, [PII]?
[CUSTOMER][POSITIVE] Yes, that will be it.
[AGENT][POSITIVE] Alrighty, well, thanks so much for calling APO Training. You have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.