AccountId: 011433970860
ContactId: dfe29530-18cc-47fe-8943-9a40680de0e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 109400 ms
Total Talk Time (AGENT): 64769 ms
Total Talk Time (CUSTOMER): 36938 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/dfe29530-18cc-47fe-8943-9a40680de0e4_20250225T21:21_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting APO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from uh South M Hospital. I wanted to verify, uh, eligibility and benefits for a member.
[AGENT][NEUTRAL] I can help with eligibility and benefits, and with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Thank you. And the policy number that we're looking at today, [PII]?
[CUSTOMER][NEUTRAL] I have 023-36059.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. I just need a contact number please, in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. This is a secondary or gap insurance and what we do is we will pick up the deductible, co-payment or co-insurance for in and out of hospital treatment, uh, treatment within a physician's office, cancer treatment, durable medical, excuse me, uh, independent labs. And so for outpatient services, um,
[AGENT][NEUTRAL] We will pick up the deductible co-payment or co-insurance up to $250 for calendar day or for inpatient services up to $500 for calendar year and that's just a verification of those benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, I'm sorry, I, I blanked that one you said the outpatient benefit. What was the, how much is it that the, uh, for outpatient?
[AGENT][NEUTRAL] It's the.
[AGENT][NEUTRAL] The outpatient is $250 per calendar day. Um, that's just a verification of benefit, not a guarantee of payment, but that is per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. All right, perfect. All right, thank you so much for your help, [PII].
[AGENT][NEUTRAL] OK, there's nothing else I can help with, thanks for contacting APL