AccountId: 011433970860
ContactId: db30882b-e330-4a63-938a-03262ddc4860
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 295480 ms
Total Talk Time (AGENT): 130801 ms
Total Talk Time (CUSTOMER): 116234 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/db30882b-e330-4a63-938a-03262ddc4860_20250117T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I was wondering if you could assist me in verifying a of patients, um, if they're active with APL at this time?
[AGENT][NEUTRAL] Thank you for, come on.
[AGENT][POSITIVE] Yes ma'am, I can help you with eligibility. Can you please give me your name and your call back number?
[CUSTOMER][NEUTRAL] Sure. My name is [PII]. Callback number is [PII]. I have no extension.
[AGENT][NEUTRAL] OK, thank you Ms. [PII], and then what is the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII], uh spelled [PII] Date of birth, [PII].
[AGENT][NEUTRAL] Thank you. And then what is Ms. [PII]'s policy number?
[CUSTOMER][NEUTRAL] Uh, his policy number is 60801.
[AGENT][NEUTRAL] OK, that is our um payer ID number to file electronically.
[CUSTOMER][NEUTRAL] Oh Lord.
[CUSTOMER][NEUTRAL] Yeah, that, that he gave me because I didn't have anything on file for him. Would I be able to give you his social so you can look him up in that way?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][NEUTRAL] OK, his social is [PII].
[AGENT][NEUTRAL] OK, let me pull him in for us with his social.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, I see why I kept calling him her because.
[AGENT][NEUTRAL] I thought it was [PII]. It's [PII]. OK, got it. It is a yes.
[CUSTOMER][NEUTRAL] Yes, uh yeah. It's OK.
[AGENT][NEUTRAL] OK, so I do see that he does have an active policy with us. Uh, his effective date is [PII].
[CUSTOMER][POSITIVE] OK, cool.
[AGENT][NEUTRAL] And let me get you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it is active, um.
[AGENT][NEUTRAL] This is a supplemental insurance policy and this is just to verify his coverage. It's not a guarantee of payment. He has a supplemental policy that is billed secondary to the primary. The policy helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] He has an inpatient benefit amount of $2000 per occurrence and it also has a benefit amount um for outpatient of $1000 per calendar day.
[CUSTOMER][NEUTRAL] OK dokey.
[CUSTOMER][NEUTRAL] Per calendar day?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So, so each day would refresh and go back to $1000. So he could go to the hospital every day and, and it would cover $1000?
[AGENT][NEUTRAL] Now the inpatient benefit amount is per occurrence per hospital stay and that's 2000.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But outpatient is 1000 per calendar day, correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Alrighty, OK, that's, well, that's nice, good.
[CUSTOMER][NEUTRAL] Um, let's see here.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Outpatient amount per calendar day. All righty. OK. Thank you so much. Uh, can I please have your name once more, the first initial to your last and a reference number for this call, please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] Lovely, thank you so much, [PII]. I really appreciate all your help.
[AGENT][POSITIVE] You're very welcome Miss [PII] thank you so much for calling APL I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Thank you. You too, [PII], before you let me go, can I ask really quickly, what is the policy number, the correct one for the APL so I can add it to his account?
[AGENT][POSITIVE] Oh yes, I should have given that to you already. I'm glad you caught that. It's 25.
[CUSTOMER][NEUTRAL] No, it's OK. I almost forgot.
[AGENT][NEUTRAL] Me too.
[AGENT][NEUTRAL] Um, it's 254-318-4.
[CUSTOMER][NEUTRAL] 184.
[CUSTOMER][POSITIVE] Awesome thank you so much [PII] I really appreciate it.
[AGENT][POSITIVE] You're welcome. You have a good weekend.
[AGENT][NEUTRAL] Bye-bye, Ms. [PII].
[CUSTOMER][NEUTRAL] You as well. Bye-bye.