AccountId: 011433970860
ContactId: eac38021-50db-4821-ba1b-127af0db8b5f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196449 ms
Total Talk Time (AGENT): 125459 ms
Total Talk Time (CUSTOMER): 36564 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/eac38021-50db-4821-ba1b-127af0db8b5f_20250123T16:00_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from Memorial Hospital. I was just needing to verify your patient's eligibility and benefits.
[AGENT][POSITIVE] All right, Ms. [PII], I'll be glad to help you. Go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] It's 016591.
[CUSTOMER][NEUTRAL] 70 ML 8.
[AGENT][POSITIVE] Alright, thank you so much for that information, [PII]. Now while I'm pulling this up, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright thanks so much for all that information, [PII]. Now what's your patient's name and date of birth today?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Alright, it looks like she is the insured on this medical supplemental plan. Let me go and see. Looks like she may have flipped to a different number though, so let me do some checking. Hang on just a second for me. Let's see.
[AGENT][NEUTRAL] Yeah, I think she did.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Yep, she did. Let me give you her correct current policy number. This will be the number that needs to be filed on the claim when you.
[AGENT][NEUTRAL] Send it into APL and that new number is gonna be 025.
[AGENT][NEUTRAL] 05679.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] 43505679
[AGENT][NEUTRAL] Yes, ma'am, that is correct, and I do show that this medical supplemental plan went into effect [PII]. It is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit. Is that correct?
[CUSTOMER][NEUTRAL] Yeah, it's for uh outpatient hospital benefits.
[AGENT][NEUTRAL] Alright, let me get that benefit pack pulled up. Let's see. OK, now what we are, of course, is her medical supplemental plan, so the only thing that we will pick up and pay on is for anything for sickness and injury that is applied towards her deductible copay or co-insurance as her primary insurance carrier. Now her benefit here is uh no pre-cert, no deductible, and she has a $2500 outpatient benefit here per calendar year.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] All right. Is there anything else I can help you for you today, [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, that would be all. Thank you. Uh, is there a reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, ma'am, we don't give reference numbers, but you can use my name in today's date, [PII], if you need to do so, and my name is [PII] spelled [PII]
[CUSTOMER][POSITIVE] Perfect thank you so much OK.
[AGENT][POSITIVE] Yes ma'am, and thanks for calling APO. You have a great rest of your day, [PII].
[CUSTOMER][NEUTRAL] You as well. Bye.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.