AccountId: 011433970860
ContactId: e334c35d-deb7-4c19-9354-a35a42620582
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427399 ms
Total Talk Time (AGENT): 128835 ms
Total Talk Time (CUSTOMER): 82979 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/e334c35d-deb7-4c19-9354-a35a42620582_20250320T19:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from a provider's office. I was hoping I could verify eligibility for a patient.
[AGENT][NEUTRAL] Yes ma'am, I can help you with eligibility, Miss [PII], can you please give me your callback number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Of course my callback number is [PII] and the facility name is Suncoast Surgical Associates.
[AGENT][NEUTRAL] OK, thank you so much and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] His name is [PII].
[CUSTOMER][NEUTRAL] If you need that spelled, I'd be happy to spell that for you as well. Um, date of birth is [PII].
[CUSTOMER][NEUTRAL] And his policy number is 02538271.
[AGENT][NEUTRAL] OK, let me pull up his policy real quick.
[AGENT][NEUTRAL] OK, I have it pulled up and I do show that he does have an active policy and his effective date is [PII].
[CUSTOMER][POSITIVE] Alrighty
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And out of curiosity, would he be eligible for emergency services?
[AGENT][NEUTRAL] Let me check and see if he has any emergency benefits on his policy.
[AGENT][NEUTRAL] It's gonna be just a second while I scan through real quick to see.
[AGENT][NEUTRAL] I'm gonna go ahead and pull his policy up and read it. I'm not seeing it at a glance. I do show that he does have outpatient benefits, um.
[AGENT][NEUTRAL] Mm let me see if it breaks it down.
[AGENT][NEUTRAL] Facility for me.
[AGENT][NEUTRAL] No, of course not. It's gonna make me look it up.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][POSITIVE] No, it's OK. I don't mind helping you at all. I just thought I was, I just don't want you to have to wait too long. It's gonna be a moment download and I can read it.
[CUSTOMER][POSITIVE] No, you're OK. You can, you can take your time.
[AGENT][POSITIVE] OK, good.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEGATIVE] It's trying to load.
[AGENT][NEUTRAL] It's pretty big.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's still loading. It's, it's about 3/4 of the way there. I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, there we go. Now let's see what it says.
[AGENT][NEUTRAL] Yes, it does have ER visits.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] It says, it says it's covered a hospital emergency room, a portion of the hospital where emergency diagnosis and treatment.
[AGENT][NEUTRAL] Sickness or injury. So it's for sickness or injury.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] And then just out of curiosity, does he have like a max benefits payable towards?
[CUSTOMER][NEUTRAL] Uh, emergency visits or anything like that?
[AGENT][NEUTRAL] Uh, let me check that for you real quick.
[AGENT][POSITIVE] It is a benefit for the
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] It's making me slide over they get 2.
[AGENT][NEUTRAL] And the benefit amount is up to $500 per calendar year per visit.
[CUSTOMER][POSITIVE] OK, OK, thank you so much for all of your help [PII] you've been great.
[AGENT][POSITIVE] Well, you're very welcome. I'm glad I was able to help you. Is there anything else I can do for you before we go?
[CUSTOMER][POSITIVE] No, I think that's all thank you so much.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, yep.
[AGENT][POSITIVE] You [PII], you have a wonderful day and thanks for calling APO.
[CUSTOMER][NEUTRAL] OK bye bye.
[AGENT][NEUTRAL] Bye-bye.