AccountId: 011433970860
ContactId: c61fd3e0-7661-46c6-8bbc-09214168890b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180630 ms
Total Talk Time (AGENT): 93489 ms
Total Talk Time (CUSTOMER): 65862 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/c61fd3e0-7661-46c6-8bbc-09214168890b_20250305T19:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] I'm calling from Pete Mont Augusta Hospital in reference to a patient here who just delivered. I did and she presented this card. I was calling to see if there's any kind of medical maternity benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure we could take a look at those benefits. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] I do. It is 02517474.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that [PII]. 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 then of course I will let you know verification of coverage is not a guarantee of payment for claims and so I'm assuming after giving birth that's generally going to be inpatient, so the inpatient benefit is let's see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] $7500.00 I'm sorry, per covered person it's going to be $2500 per calendar year.
[CUSTOMER][NEUTRAL] OK, do you show to her to have used any of that as of now?
[AGENT][NEUTRAL] Let me check that one moment.
[AGENT][NEUTRAL] No, I'm not showing that any benefits have been used so far.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Suit to date, awesome. um.
[CUSTOMER][NEUTRAL] And I'm sorry, did you say that's like what the, the, I'm sorry, the amount that would be paid by you guys?
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Right, that's this benefit amount.
[CUSTOMER][NEGATIVE] Not like the deductible.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, benefit amount.
[CUSTOMER][POSITIVE] No deductible. Awesome and would you happen to know if like a notification or pre-cert is needed?
[AGENT][NEUTRAL] No, um, as this policy is very dependent on, uh, major medical whoever she has as her primary, so as long as they're willing to pay this policy can. If they don't, then this policy can't.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it follows the guidelines of the primary payer.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Alright, and is this just a call reference number for today's call?
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. Uh so my name is spelled [PII], last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No ma'am, you've covered it all thank you so much.
[AGENT][POSITIVE] Alright, you're very welcome. Thanks for calling APL. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thanks bye bye.