AccountId: 011433970860
ContactId: c6084fe2-a93c-4af6-80a4-3f2a65506625
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171080 ms
Total Talk Time (AGENT): 82841 ms
Total Talk Time (CUSTOMER): 70454 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/c6084fe2-a93c-4af6-80a4-3f2a65506625_20250226T18:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how are you? I'm calling from Nicola Children Hospital in regards to eligibility and benefits on one of your members.
[AGENT][POSITIVE] Sure, I can check li benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII] The first initial of my last name is [PII]. Could you please spell out your first name for me?
[AGENT][NEUTRAL] Sure, it's [PII] and my last initial is [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Oh, yes, it's 02507924 ML8.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It is [PII]. It's [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to check the outpatient benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient benefits, please.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is $3500 max per calendar year and if you'll give me one moment I'll see if any of that has been used.
[AGENT][NEUTRAL] OK, so [PII] has used $282.29 so far this year.
[CUSTOMER][NEUTRAL] Can you repeat the amount?
[AGENT][NEUTRAL] Yes, $282.29.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] OK. OK, [PII]. Um, um, thank you very much for your help. Uh, um, as is required for X-ray?
[AGENT][NEUTRAL] Of course
[AGENT][NEUTRAL] No authorization is not required for this policy.
[CUSTOMER][NEUTRAL] And that required. OK. OK. Is there any reference number for this call?
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. And was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, no, I'm OK. So far so good. Thank you very much. Bye-bye. Have a wonderful afternoon. Bye-bye. Bye-bye.
[AGENT][POSITIVE] All right, thanks. You too. Bye bye.