AccountId: 011433970860
ContactId: f6709a70-c154-45af-b7f0-48b76a77ecdd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214970 ms
Total Talk Time (AGENT): 108542 ms
Total Talk Time (CUSTOMER): 81082 ms
Interruptions: 1
Overall Sentiment: AGENT=2.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/f6709a70-c154-45af-b7f0-48b76a77ecdd_20250102T15:33_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hey, I just need to verify uh benefits and eligibility for a patient.
[AGENT][POSITIVE] Yeah, I'd love to help you with that today, and may I have
[AGENT][NEUTRAL] The policy number you're wanting to look at today, ma'am?
[CUSTOMER][NEUTRAL] Um, yes, it is let me get it off his card.
[CUSTOMER][NEUTRAL] It is 02.
[CUSTOMER][NEUTRAL] 359305
[AGENT][POSITIVE] Wonderful, thank you. And while I'm getting that policy pulled up, do you mind if I also get your name and
[AGENT][NEUTRAL] He could call back number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and a good call back number for me is [PII] and that's the direct number.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you very much. I appreciate that. And what is your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Wonderful thank you so much and you said you were just looking for eligibility and benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, your patient is current and active. They have an effective date of [PII]. And then as far as benefits go, are we looking for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] This is gonna be outpatient
[AGENT][POSITIVE] Perfect. Your outpatient benefits for this patient are gonna be.
[AGENT][NEUTRAL] Hold on, let me open this up.
[AGENT][POSITIVE] OK, sorry, thank you so much um.
[AGENT][NEUTRAL] Your patient has $3500 in benefits and it's actually combined with their inpatient and outpatient benefits.
[AGENT][NEUTRAL] And it does look like they have a deductible for accidents, um, but only for accident, oh no, accident and sickness, I'm sorry, um, for outpatient, and that deductible is $3000.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] That is all I see on here. I'm sorry. Thanks for your patience.
[CUSTOMER][NEUTRAL] No, that's OK, thank you. That's really kind of what I need. I just wanna make sure, um, you know, he would be covered with this, and I was, I have that he has a secondary insurance. Do you know if this would, uh, if APL would be?
[AGENT][POSITIVE] Yeah, we're their secondary for sure.
[CUSTOMER][NEUTRAL] Oh secondary? OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me fix that in here because we have blue here looks like he has Blue Cross also, so I'm guessing that would be primary and y'all would be secondary.
[AGENT][NEUTRAL] Mhm, yep.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, I just wanna make sure and what was.
[AGENT][NEUTRAL] And then I do wanna let you know Miss [PII] as well just uh for the sake of saying it is that any benefits we give over the phone is always just a verification of coverage and never guarantee payments.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, absolutely, and what was your name?
[AGENT][NEUTRAL] It's [PII], first initial last name, [PII].
[CUSTOMER][NEUTRAL] Alright, and you have some type of call reference number or just your user name?
[AGENT][NEUTRAL] It's my name and today's date.
[CUSTOMER][NEUTRAL] And today's date, which I cannot believe it is January. How crazy is that?
[AGENT][POSITIVE] I know. I'm so excited and a little baffled.
[CUSTOMER][POSITIVE] Yeah, a mix of both, I think, yeah, for sure. Alright, well that's all I needed I appreciate your help.
[AGENT][POSITIVE] My pleasure, Ms. [PII]. Thanks for calling APL. You have a wonderful day and a [PII].
[CUSTOMER][POSITIVE] You too alright bye bye.
[AGENT][POSITIVE] Thanks. Bye bye.