AccountId: 011433970860
ContactId: e9fff7b9-e951-4e18-bed8-ceab3972c319
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172779 ms
Total Talk Time (AGENT): 69099 ms
Total Talk Time (CUSTOMER): 83168 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/e9fff7b9-e951-4e18-bed8-ceab3972c319_20250106T16:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] How you doing, [PII]? This is [PII] coming from West Kon Baptist Hospital. I'm calling you. I have a, a member of yours, um, trying to check your benefits, so check him, the benefits for this patient.
[AGENT][POSITIVE] OK, well, I can definitely help you with the benefits. And did you need the eligibility as well or just benefits?
[CUSTOMER][NEUTRAL] Uh huh, uh, eligibility and benefits so mhm.
[AGENT][NEUTRAL] Eligibility as well.
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I have a group number and I have a payer ID.
[AGENT][NEUTRAL] That's the only numbers you have?
[CUSTOMER][NEUTRAL] Mhm. And then I have a hospital certificate numbers on the bottom.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's the policy number.
[CUSTOMER][NEUTRAL] OK, so let me give you that it says 024.
[CUSTOMER][NEUTRAL] 8306.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] ML 7.
[CUSTOMER][NEUTRAL] And I also have another one just with a different it's just an 8, the outpatient.
[AGENT][NEUTRAL] Wait, say that one more time.
[CUSTOMER][NEUTRAL] I have it in hospital benefit center certification and an outpatient benefit certification.
[AGENT][NEUTRAL] 000, the numbers are the same. That ML 7 or 8 at the end is different, but that's the policy number though. Um, and [PII], um, can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh mhm.
[CUSTOMER][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] First name says [PII] and thing is I [PII]. Look at this. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it's gonna be outpatient settings for hospital, hospital outpatients.
[AGENT][NEUTRAL] OK, so for outpatient, the um max is $1500 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did you want to see if any has been used for [PII]?
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] Um, so they have not used any of their benefits for this year yet.
[CUSTOMER][POSITIVE] OK perfect thank you so I'll just go ahead and um got it.
[CUSTOMER][NEUTRAL] Let me go ahead and put that information in there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you very much for your help. OK, [PII]. Do you have a reference code for this call?
[AGENT][POSITIVE] You're very welcome, [PII].
[AGENT][NEUTRAL] Um, there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you [PII] have a good day.
[AGENT][POSITIVE] You're very welcome and thanks for calling APR. Have a great day.
[CUSTOMER][NEUTRAL] You too.