AccountId: 011433970860
ContactId: f729643e-a72e-49ee-899f-5f76f89953f2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197490 ms
Total Talk Time (AGENT): 73840 ms
Total Talk Time (CUSTOMER): 87681 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/f729643e-a72e-49ee-899f-5f76f89953f2_20250428T15:31_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, can you give me the initial first initial of your last name?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] OK, hi, I'm calling from Broad Health in [PII], and um we have one of your members here inpatient and I just need to verify um eligibility of coverage.
[AGENT][POSITIVE] OK, well I can definitely help you with the eligibility and may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII] as the first initial of last name and um number [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure, just one second, it's 025167667.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, I can't pronounce it, so it's [PII] That's the first name. The last name is hyphenated. It's [PII] [PII] and the second name is [PII] The date of birth [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And you said inpatient?
[AGENT][NEUTRAL] So the inpatient max is $5000 per calendar year. Did you want me to see if any has been used for 2024? I'm sorry, 5.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] All right, and so far he has not used any of the inpatient benefits, so he still has the full balance.
[CUSTOMER][NEUTRAL] OK, so 5000 max for for 2025.
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] And are the
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, any co-payment or anything?
[AGENT][NEUTRAL] No, so this is their secondary policy, so we pay towards the copay, deductible and co-insurance of coverage charges up to the 5000 after Florida Blue.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] All right
[CUSTOMER][NEUTRAL] And the, the policy is in good standing and there's no cut off date or anything.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] In terms of when claims would be paid, OK.
[CUSTOMER][NEUTRAL] All right, thank you. Do you have a call reference Ano?
[AGENT][NEUTRAL] So all the information provided was a verification of benefits, not a guarantee of payments, and no, there's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. I hope you have a good day. Bye bye.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] You too bye.