AccountId: 011433970860
ContactId: dc69ea2a-a19f-42d1-b177-93cfde26749d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 145460 ms
Total Talk Time (AGENT): 60129 ms
Total Talk Time (CUSTOMER): 60093 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/dc69ea2a-a19f-42d1-b177-93cfde26749d_20250519T18:14_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from AdventHealth Palm Coast. I was trying to verify members eligibility and benefits.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Yes, that'd be [PII] and that's a direct line.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number is 2304274.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And are you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Uh, this is regarding outpatient benefits. She's coming in for an X-ray.
[AGENT][NEUTRAL] I do show.
[AGENT][NEUTRAL] OK, I do show the outpatient calendar year maximum is $1500.
[CUSTOMER][POSITIVE] Alright, thank you.
[CUSTOMER][NEUTRAL] Uh, are there any accumulations?
[AGENT][NEUTRAL] Was there anything else I can assist with today?
[AGENT][NEUTRAL] Um, let's see, she has used.
[CUSTOMER][NEUTRAL] Uh, are there?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Not for outpatient, she hasn't used any she has the full amount available.
[CUSTOMER][NEUTRAL] Alright, OK, and you say this is the out of pocket. Does she have a deductible?
[AGENT][NEUTRAL] We're
[AGENT][NEUTRAL] Gap insurance. So that would be a question for her.
[CUSTOMER][NEUTRAL] Oh this, oh this is a this is, this, this is OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's a yeah, that's a question for a major medical.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, you all you all out of me gap then, right?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mm, not me a gap, but we're her gap policy, commercial gap policy.
[CUSTOMER][NEUTRAL] Second, oh, OK, commercial gap policy, alright.
[CUSTOMER][NEUTRAL] Oh well thanks [PII]. I think that's all that I need. Is there any way you can provide me a call reference number?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call.
[CUSTOMER][POSITIVE] All right thank you so much have a great rest of the day.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye