AccountId: 011433970860
ContactId: c3b804c9-7cea-4947-952f-6d53b9cd2c5f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 141669 ms
Total Talk Time (AGENT): 76898 ms
Total Talk Time (CUSTOMER): 47654 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/c3b804c9-7cea-4947-952f-6d53b9cd2c5f_20250115T14:43_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling to verify patients eligibility.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, I'll need a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] My callback number is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] It is 02336028 ML 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] His name is [PII]. Uh, date of birth is [PII].
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] It was for emergency, um, but he wasn't hospitalized, I guess outpatient.
[CUSTOMER][NEUTRAL] But it's, it, it's emergency.
[AGENT][NEUTRAL] OK. For emergency room visits, we cover up to $250 per day and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim. And if he's admitted, um, that'll be covered also under the inpatient benefit for the inpatient charges, and we cover up to $500 per calendar year. Are you checking on the status of the claim?
[CUSTOMER][NEUTRAL] No, I just wanted to verify eligibility, um, but I got what I got the information that I needed. Can I just have your name and the reference call number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. So the reference number, you can use my name and today's date. My name is [PII] um it's spelled [PII] My last initial is [PII], and today's date for the reference number. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that's all thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] You as well take care bye bye.
[AGENT][POSITIVE] Mm thank you.