AccountId: 011433970860
ContactId: ed10c7c5-f30e-4ce0-8ebf-6a932191fb09
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 137710 ms
Total Talk Time (AGENT): 73644 ms
Total Talk Time (CUSTOMER): 56153 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/ed10c7c5-f30e-4ce0-8ebf-6a932191fb09_20250121T19:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] and I'm calling from Baptist Homestead Hospital in [PII], and we had uh one of your, uh,
[CUSTOMER][NEUTRAL] Subscribers yesterday here in the ER but since it was a holiday, we weren't able to verify his benefits. Can you help me with that today?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Of course we could take a look at the eligibility and benefits. You did say your name was [PII]. I'm sorry.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, first, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII]. OK. And then do you have the uh policy number?
[CUSTOMER][NEUTRAL] OK, let me see what I get here. Policy number I have 0184.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 7240 ML
[CUSTOMER][NEUTRAL] 8
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] His name is [PII] and the last name is [PII]
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK, perfect, thank you for verifying that [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and you did say it was uh an emergency room visit, correct?
[CUSTOMER][NEUTRAL] Yes it was.
[AGENT][NEUTRAL] OK, one moment, of course I will let you know verification of coverage is not a guarantee of payment for claims, so that would fall under their outpatient benefit which is $1250 max per calendar year, and I know the year just started, but I will check to see if any of that has been used.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK, none has been used so far this year.
[CUSTOMER][POSITIVE] OK, OK, wonderful, thank you so much I appreciate your your help. No, that's it thank you have a great day.
[AGENT][NEUTRAL] Yeah, was there anything else I could help you with? Of course.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye bye.