AccountId: 011433970860
ContactId: c9be0c56-d6a2-4faf-b0d9-6d6c291d24eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200460 ms
Total Talk Time (AGENT): 82890 ms
Total Talk Time (CUSTOMER): 91132 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/c9be0c56-d6a2-4faf-b0d9-6d6c291d24eb_20250520T13:42_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], and I'm calling from Amerigroup Texas Medicaid to get eligibility on a member, please.
[AGENT][POSITIVE] All right. Happy to check eligibility today. Can I get the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02592877.
[AGENT][POSITIVE] All right. Thank you.
[AGENT][NEUTRAL] And then if I could get the patient's name and date of birth please, [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am. The patient's name is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][POSITIVE] Thank you so much. So patient is active. The effective date on here is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] and is this a commercial policy?
[AGENT][NEUTRAL] Yeah, so it looks like.
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] OK, and is this a PPO policy with pharmacy benefits? And if so, who is the pharmacy PBM?
[AGENT][NEUTRAL] So it's a limited benefit plan, hospital indemnity, uh, so it's not a major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Limited, OK. Indemnity plan. OK. So since it's a limited and indemnity plan, do it pays to the patient or the provider?
[AGENT][NEUTRAL] Um, it can pay to either depending upon who's filing the claim, yeah, so if the provider's filing the claim, then the payment will go to the provider.
[CUSTOMER][NEUTRAL] Either.
[CUSTOMER][NEUTRAL] OK. So you said uh uh a Deity Hospital.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Policy or what did you say?
[AGENT][NEUTRAL] Yeah, it's a limited benefit hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, uh, it's a hospital plan.
[CUSTOMER][NEUTRAL] I'm just trying to get the correct words to say on this one.
[AGENT][NEUTRAL] No, that, that's OK.
[CUSTOMER][NEUTRAL] Um, so it don't say it's just a limited deity plan. It don't have like PPO or pharm they do have pharmacy benefits.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] It does have pharmacy benefits, but yeah, it's just gonna pay like a set amount depending upon what it's for, um, so it's not like a percentage like a PPO or anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, and can I get a reference number please?
[AGENT][NEUTRAL] Absolutely. Call reference is gonna be my name with my last initial and then today's date. My name is [PII], that's [PII] The initial to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] Thank you and you have a great rest of your day and week.
[AGENT][POSITIVE] You, you too, [PII]. Take care.
[CUSTOMER][NEUTRAL] All right bye bye.
[AGENT][NEUTRAL] Bye bye.