AccountId: 011433970860
ContactId: d6db0e05-1a33-4923-9090-dff490074081
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 151600 ms
Total Talk Time (AGENT): 66027 ms
Total Talk Time (CUSTOMER): 75936 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/d6db0e05-1a33-4923-9090-dff490074081_20250514T21:17_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. My name is [PII] and I'm with Memorial Herman Hospital. I'm trying to uh verify benefits, uh, for a patient, please.
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with the the benefits and uh did you need eligibility also?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Mhm. Uh yes, my direct line is [PII]. Let me see if I can read this policy. It's 022800 and it looks like a 20.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh. [PII], and it is uh [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, he's coming in for, uh, a bar and wallet. It's an outpatient, uh, test. He has Blue Cross as a primary policy, so, um, I just need you to see how this plan is gonna coordinate with Blue his primary plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it's outpatient, is it diagnostic testing?
[CUSTOMER][NEUTRAL] Yes, mhm, it's an X-ray. Mhm.
[AGENT][NEUTRAL] OK. So for outpatient, the policy would pay up to $3500 for outpatient expenses. Um, so we are second to Blue Cross Blue Shield. So, um, we apply to the co-pay, deductible and co-insurance after primary.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All [PII]. OK. Well, I think I have everything else loaded.
[CUSTOMER][NEUTRAL] In my system, uh, [PII], and what's your, uh, last initial?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK, is there a call reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, Ms. [PII], thank you so much for your help.
[AGENT][NEUTRAL] Alright.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] All right, have a good evening. Bye bye.
[CUSTOMER][POSITIVE] You too. Thank you.