AccountId: 011433970860
ContactId: f01caecc-3467-4e12-a50e-e1d2babe193e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215220 ms
Total Talk Time (AGENT): 124424 ms
Total Talk Time (CUSTOMER): 53539 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/f01caecc-3467-4e12-a50e-e1d2babe193e_20250218T15:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], good morning. I'm calling from Nicholas Children's Hospital. Um, was calling to verify benefits for a patient.
[AGENT][POSITIVE] Yeah, I can take benefits for you. um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Oh [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, then [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] I do 016.
[CUSTOMER][NEUTRAL] 99,830.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK and uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. So this policy actually terminated, uh, [PII]. If you'll give me one moment, I'll see if they have one that's active, might just be a different policy number.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK, and this was for [PII]?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so they do have one that is currently active. Let me know when you're ready. I'll give you, excuse me, I can give you that policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, that is 0 02473106.
[CUSTOMER][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, so this one is.
[CUSTOMER][NEUTRAL] And that one is
[AGENT][NEUTRAL] Yes, it is currently active. That's OK. Um, uh, effective date for this one was [PII] and where we needing to look at the outpatient benefits?
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Yes, you can quote both outpatient and patient in case.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, of course, and then just so that you are aware this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So the outpatient benefit is on a per calendar day basis, so it would pay up to $300 per calendar day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Inpatient is going to be um per consignment, so it is $3000 max uh per confinement.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the address where to submit the claims?
[AGENT][NEUTRAL] Sure, I've got a mailing address, fax number and a payer ID, um, so the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Alrighty, did you need that fax number or payer ID as well?
[CUSTOMER][POSITIVE] No, no, no, that's it. Thank you so much, [PII].
[AGENT][NEUTRAL] OK, alright, was there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it thank you have a nice day.
[AGENT][POSITIVE] All right, yeah, thanks for calling APL. You too. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.