AccountId: 011433970860
ContactId: c4f6a97b-2c8c-452b-b0dd-e8f0d7b13498
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308179 ms
Total Talk Time (AGENT): 107974 ms
Total Talk Time (CUSTOMER): 132903 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/c4f6a97b-2c8c-452b-b0dd-e8f0d7b13498_20250620T15:13_UTC.wav
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[AGENT][NEUTRAL] Morning, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] here. Last name of the first letter is [PII] M calling from the Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK, uh, and how may I assist you today?
[CUSTOMER][NEUTRAL] Can you hear me? Hello?
[AGENT][POSITIVE] Yes, Mr. [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yeah, I have a patient with me to check whether the patient is.
[CUSTOMER][NEUTRAL] Yes, thank you. Uh, I need to check whether the patient is active with this plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, sure. I can assist you with the eligibility. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][POSITIVE] That's perfect.
[AGENT][NEUTRAL] OK, thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02.
[CUSTOMER][NEUTRAL] 22058 ML 8.
[AGENT][NEUTRAL] Um, let me have that number one more time. That wasn't enough numbers.
[AGENT][NEUTRAL] 0
[CUSTOMER][NEUTRAL] OK, I'll just repeat that it's 02042058 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] And the last name is [PII] First name is [PII], [PII]
[CUSTOMER][NEUTRAL] I got a date of birth for this patient?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, it's [PII]. It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And you say you need eligibility. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, can I get an annual calendar value for this patient?
[AGENT][NEUTRAL] A what? I'm sorry.
[CUSTOMER][NEUTRAL] It's for the annual calendar value for this patient secondary plan there's a value for this patient.
[AGENT][NEUTRAL] You need the benefits for what type of service?
[CUSTOMER][NEUTRAL] Yeah, that's right. I need to know the value what the patient has in uh out of pocket.
[AGENT][NEUTRAL] What type of service, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK. Uh, um, I think, uh, I want to know about this. The patient has a secondary insurance which pays half of the payment from the secondary insurance payable. So there will be a value like element can value, what is the uh amount the patient has like that.
[AGENT][NEUTRAL] OK, um, Mr. [PII], for me to give you a benefit, I need to know if you're looking for inpatient, outpatient, office, urgent care, surgery. I need to know what type of service is being rendered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Outpatient as well.
[AGENT][NEUTRAL] OK, outpatient.
[CUSTOMER][NEUTRAL] Sorry for that. It's outpatient hospital.
[AGENT][NEUTRAL] OK. All right, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer, and we have an outpatient maximum of 1500 per year per covered person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 1500, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, thanks for the information. May I know, may I know your name? Could you please spell your name?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure. That's [PII]. That's initial [PII]. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, I'm done with this. Can I get a call reference number for this?
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK, SOLM 06202025, right?
[AGENT][NEUTRAL] SOL last initial M. Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 060 06202025 I can use the today date right for this caller reference number.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you. Thank you so much. So thank you. I'm done with this. Thank you. Have a great day. Bye-bye.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] You as well, Mr. [PII]. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.