AccountId: 011433970860
ContactId: da889367-e563-4488-8e6e-9a7f2367c363
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160509 ms
Total Talk Time (AGENT): 63866 ms
Total Talk Time (CUSTOMER): 91971 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/da889367-e563-4488-8e6e-9a7f2367c363_20250513T17:50_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi, uh, this is [PII] with the Boca Raton Regional Hospital calling to verify a member's, um, benefits.
[AGENT][NEUTRAL] Sure, may I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] OK, and my, um, my callback number is [PII].
[AGENT][NEUTRAL] And the policy number of the member that you're calling to verify outpatient benefits for?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. She, the patient wasn't sure, but this is the only number she has, she said. It's 021-69009 M as in Mary, L as in Larry and number 8.
[AGENT][NEUTRAL] And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] It's um uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, May. This is the correct policy number. This policy has been active since [PII] and it's currently active.
[CUSTOMER][POSITIVE] OK good.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She has outpatient benefits of $500 per calendar day for this gap insurance policy that assists the primary with deductible co-pay and co-insurance, and this is not a guarantee of benefits that a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] And she has a
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so she has a maximum of 500 per day?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] For an outpatient, she's because she's, she's coming in for an outpatient surgery and she has a $500 co-pay so this is this it'll be covered then, right?
[AGENT][NEUTRAL] No, no, she's, it says she has, well, it says this policy is a $500 deductible that would assist with her deductible co-pay and co-insurance, yes.
[CUSTOMER][NEUTRAL] Oh, OK. So, yeah, so she has a $500 co-pay from her primary insurance. Then this will cover, wouldn't it? This this insurance will cover?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, that is correct. You will submit the claim here along with the ELB from the primary insurance company.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, we, we're gonna submit to primary first and then it then to you, right? OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, so she has enough coverage because it, it just, yeah, her co-pay is uh 500 from her primary, so this, this policy will cover her co-pay. OK.
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][NEUTRAL] All right. OK, good. Um, can I have your name, please?
[AGENT][NEUTRAL] [PII]. Today's date of the reference made because we don't provide reference numbers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, very good, [PII], thank you for your help today.
[AGENT][POSITIVE] You're welcome thanks for calling APR. Have a great day. Goodbye.
[CUSTOMER][NEUTRAL] OK bye bye.