AccountId: 011433970860
ContactId: cf1b1e09-6137-4180-9ba7-b1504bf2204b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270059 ms
Total Talk Time (AGENT): 99026 ms
Total Talk Time (CUSTOMER): 112989 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/cf1b1e09-6137-4180-9ba7-b1504bf2204b_20250414T18:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from Homestead Hospital's pre-registration department. Uh, to verify a member's gap insurance with this American Public Life Insurance Company.
[AGENT][NEUTRAL] Um, sure, [PII], I can assist you with benefits. Um, first, could I get a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] 0283620 ML 8.
[AGENT][NEUTRAL] OK. Please repeat that policy number.
[CUSTOMER][NEUTRAL] 0283620
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK, no one's coming up under that number. I could try to look them up by their social or name and date of birth.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] There's another number here in the system. I don't know if this is current or not it's a 023198.
[CUSTOMER][NEUTRAL] 35 ML 7.
[AGENT][NEUTRAL] OK, and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] or [PII].
[CUSTOMER][NEUTRAL] Uh something like that, [PII], I think she says.
[AGENT][NEUTRAL] OK. And the date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII] and it's for a hospital outpatient.
[AGENT][NEUTRAL] OK, just let me advise you that verification of coverage does not guarantee payment of claims, and he does have a new policy number. Let me give you that.
[CUSTOMER][NEUTRAL] OK. All right, go ahead.
[AGENT][NEUTRAL] It is 02583620.
[CUSTOMER][NEUTRAL] Oh, it's the same as what you gave me, but you you don't put the ML 8 on the end of it.
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, just 02583620 because she read it from the card just now and she gave it ML 8. OK.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, so, go ahead.
[AGENT][NEUTRAL] The effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] It's, it's hospital outpatient surgery.
[AGENT][NEUTRAL] OK. OK. For outpatient, we cover up to 1250 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, so you pay 1250 for outpatient hospital surgery.
[AGENT][NEUTRAL] Yes, ma'am, per calendar year.
[CUSTOMER][NEUTRAL] OK, per year and then what do we have available?
[AGENT][NEUTRAL] Um, well, so far this year, he's used $60.69. That's how much he has used.
[CUSTOMER][NEUTRAL] So what's your how what is the remaining balance right now?
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] 1189 and 31 cents.
[CUSTOMER][NEUTRAL] 118931 available hospital outpatient.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Hospital outpatient.
[CUSTOMER][NEUTRAL] OK, and then your first name and the first is of your last name and call someone for the call.
[AGENT][NEUTRAL] Um, for the reference number, you can use my name in today's date. My name is [PII] spelled [PII] Last initial is [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Let me make sure I have the right.
[CUSTOMER][NEUTRAL] Billing address. I have a [PII].
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][POSITIVE] All right, [PII], thank you so much for your help. [PII] bless. Have a good day, ma'am.
[AGENT][NEUTRAL] Mhm. You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.