AccountId: 011433970860
ContactId: f354f005-1e9d-4b72-b99f-cee7f7a1ff2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257369 ms
Total Talk Time (AGENT): 125404 ms
Total Talk Time (CUSTOMER): 70696 ms
Interruptions: 2
Overall Sentiment: AGENT=2.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/f354f005-1e9d-4b72-b99f-cee7f7a1ff2e_20250115T13:02_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], this is [PII] calling from Jackson Memorial Hospital. How are you this morning?
[AGENT][POSITIVE] I'm good, [PII]. How are you today?
[CUSTOMER][NEUTRAL] I am fine. I am calling to check the um eligibility for one of our mutual patients please.
[AGENT][POSITIVE] Good.
[AGENT][NEUTRAL] OK, [PII], so do you, you only need to know if the policy is active or not? You do not need benefits?
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Uh, both.
[AGENT][NEUTRAL] You need both eligibility and benefits, OK, yes ma'am, I can help you with those things. and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02399328 ML 8.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah, yeah
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, it's under [PII], but it's for her son [PII].
[AGENT][NEUTRAL] OK, and his date of birth?
[CUSTOMER][NEUTRAL] [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] so
[CUSTOMER][NEUTRAL] Being down
[AGENT][NEUTRAL] And are you needing inpatient, outpatient or office benefits? Outpatient, OK.
[CUSTOMER][NEUTRAL] Outpatient
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, so I do show that [PII] is a cover dependent under the supplemental policy, and this policy is active and the effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And one moment for your benefit information.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] So there is an outpatient benefit maximum of $500 per calendar day per covered person for covered outpatient services, with no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, OK, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And because this is a supplement, you may already know this, [PII], but because this is a supplement to the primary insurance, we will have to have a copy of the primary insurance company's EOB with the claim, and then we also have our portals that our claim status can be checked in.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Of the primary insurance, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is the website for that is [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK alrighty thank you so much, [PII].
[AGENT][POSITIVE] Well, you are certainly very welcome [PII], and if you need a call reference number, it's my name and today's date. Yes ma'am.
[CUSTOMER][NEUTRAL] I do, please, your name and today's date, OK.
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][POSITIVE] Alrighty thank you so much.
[AGENT][POSITIVE] Well, you are very welcome. So if that's all I can help you with, thank you again for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.