AccountId: 011433970860
ContactId: e845e133-482e-44fd-884f-4264b827a473
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226699 ms
Total Talk Time (AGENT): 87857 ms
Total Talk Time (CUSTOMER): 98627 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/e845e133-482e-44fd-884f-4264b827a473_20250521T19:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hi sorry can you repeat your name one more time?
[AGENT][NEUTRAL] Sure, it's [PII]
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Thank you. Um, my name is [PII]. I'm calling from Eminent Health Orthopedics just to verify this member eligibility, and, um, it looks like it's for a supplemental plan.
[AGENT][NEUTRAL] OK, I can verify eligibility and benefits for you. And Ms. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] On the card, it just has a group number and then at the bottom it has 2 ID numbers.
[AGENT][NEUTRAL] What is either inpatient or outpatient number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] 02467129 M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] OK, thank you and do you have a callback number in case the call drops?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes, that's [PII] and my extension is [PII].
[AGENT][NEUTRAL] Thank you and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, I'm showing that policy number you gave it terminated [PII], so when you're ready I can give you the current uh policy number.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] OK, it's 251-945-7.
[AGENT][NEUTRAL] Effective date is um [PII] and the policy is active.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you say you're also needing benefits?
[CUSTOMER][NEUTRAL] Uh, yes, this one's for, uh, it's for specialist office visit, but, uh, it's performed outpatient hospital setting.
[CUSTOMER][NEUTRAL] So we bill as 22.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment, just verification of coverage. With this policy as secondary, it helps with primary insurance deductible, co-pay, and or co-insurance, and they have an outpatient benefit max up to $2,025 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] And has any anything been applied to that?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, no, ma'am. So it is available.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK. And then you said this coverage helps with her uh deductibles, co-insurance, and what else?
[AGENT][NEUTRAL] Her primary deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] And culture, OK.
[CUSTOMER][NEUTRAL] And then uh just to confirm the claims address is the [PII].
[AGENT][POSITIVE] Uh, that is correct, yes ma'am.
[CUSTOMER][NEUTRAL] OK, got it. And lastly, if I could just get a reference number for the call.
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Got it. OK, thanks for your help.
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling APL, [PII]. Have a great day.
[CUSTOMER][POSITIVE] You too thank you bye bye.