AccountId: 011433970860
ContactId: e09c0637-bb7d-4ff3-b423-f76caf92d923
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248059 ms
Total Talk Time (AGENT): 90610 ms
Total Talk Time (CUSTOMER): 86177 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/e09c0637-bb7d-4ff3-b423-f76caf92d923_20250402T19:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from Cardiology Healthcare, um, to see if I can find out the eligibility and benefits of a patient.
[AGENT][NEUTRAL] OK, I can help you with both eligibility and benefits. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] Phone number is [PII].
[AGENT][NEUTRAL] Can you
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and can you spell your first name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, Ms. [PII], and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK, his name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] And the policy number is, give me one second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] 02519166.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my family
[AGENT][NEUTRAL] I do show that [PII] does have an active policy with us. The effective date of the policy is [PII].
[CUSTOMER][NEUTRAL] I request.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] And this is just to verify coverage. It's not a guarantee of payment. He has a supplemental insurance policy that's billed secondary to the primary. It helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So please.
[AGENT][NEUTRAL] He has an inpatient benefit amount of $1650.
[AGENT][NEUTRAL] And he has an outpatient benefit amount per calendar day of $300.
[CUSTOMER][NEUTRAL] Payroll order
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK, does this cover, does it cover, um, co-payments for follow up consults with the specialist?
[AGENT][NEUTRAL] In a specialist's office?
[CUSTOMER][NEUTRAL] Yeah, the co-payment.
[AGENT][NEUTRAL] OK, let me look and see if office visits are covered under this, right, I'm gonna check to see if he has, um, office visits on his plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Give me just a moment while I pull it up.
[AGENT][NEUTRAL] OK, so he does have treatment in the office, but it does not include the physician's office visit fee.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] No, that'll be it.
[AGENT][POSITIVE] Alright Miss [PII], I hope you have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][NEUTRAL] Mm, bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.