AccountId: 011433970860
ContactId: e46fd3ef-4b6a-4e78-a268-151533af176f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239679 ms
Total Talk Time (AGENT): 85450 ms
Total Talk Time (CUSTOMER): 53767 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/e46fd3ef-4b6a-4e78-a268-151533af176f_20250515T19:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][POSITIVE] Oh hi. I'm going to um verify benefits for a member, please.
[AGENT][POSITIVE] OK, yes ma'am, I can verify benefits for you and your name is?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm calling from Houston Methodist Hospital.
[AGENT][NEUTRAL] OK, and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] It is, excuse me, 02580148.
[AGENT][POSITIVE] OK, thank you. Give me one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. My direct number is [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Uh, [PII], and uh date of birth is [PII].
[AGENT][NEUTRAL] OK, and you say you're calling to verify benefits and eligibility, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] I show her effective date is [PII] and she is active on the policy.
[CUSTOMER][NEUTRAL] OK. Is there a deductible or out of pocket?
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Is this for outpatient or in hospital?
[CUSTOMER][NEUTRAL] I have a CPT code. Do you, uh, do you need that?
[AGENT][NEUTRAL] No ma'am, is this gonna be performed in an outpatient facility or inpatient?
[CUSTOMER][NEUTRAL] So it's outpatient uh hospital setting.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] I don't well, she has a deductible, but it's only for ER, but um.
[AGENT][NEUTRAL] This policy she has with us is a secondary supplemental plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So no deductible, no out of pocket?
[AGENT][NEUTRAL] Uh, not for just regular outpatient, but if it's an ER, there's a deductible and there's a max benefit, but there's no co-pay or co-insurance on the plan.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and it's
[CUSTOMER][NEUTRAL] Uh, do you have a call reference number?
[AGENT][NEUTRAL] Uh, if you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] OK. Could you spell your uh name, please, and give me the last name initial?
[AGENT][NEUTRAL] Yes, ma'am. It is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and Miss [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] That would be all. Thank you very much, ma'am.
[AGENT][POSITIVE] Yes ma'am, thanks for calling APL have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye.