AccountId: 011433970860
ContactId: fae98bc0-91f1-4498-b191-bb5b9e9d156e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203259 ms
Total Talk Time (AGENT): 90820 ms
Total Talk Time (CUSTOMER): 83424 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/fae98bc0-91f1-4498-b191-bb5b9e9d156e_20250218T17:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] So, are you saying?
[CUSTOMER][NEUTRAL] [PII] A [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, APL. OK, this is [PII]. I'm calling from Houston Methodist Hospital, um, to verify eligibility and benefits, uh, for outpatient, uh, surgery for a member, please.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits, Ms. [PII]. Can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] [PII] 486 9.
[CUSTOMER][NEUTRAL] 2267455
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you see another number?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 222674 55 no.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so her date of birth is [PII]. And then her pals.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] 486 9. What did I say?
[AGENT][NEUTRAL] You, you said it all together, so I thought it was one policy number. That's OK. I think I've got it figured out now though.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, sorry.
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] All right, so I do see that [PII] does have an active policy with us.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And her effective date is [PII].
[AGENT][NEUTRAL] I'm sorry, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify her coverage. It's not a guarantee of payment. She has a supplemental insurance policy. It's a gap insurance that helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Helps with deductible copay.
[CUSTOMER][NEUTRAL] And coinsurance, OK.
[AGENT][NEUTRAL] Yes, ma'am, and she has an inpatient benefit amount of $6000 per calendar year, and she also has an outpatient benefit amount of $6000 per calendar year.
[CUSTOMER][NEUTRAL] Benefit outpatient benefit amount $6000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] She has primary coverage.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, how did you guys pay?
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] We
[AGENT][NEUTRAL] We pay secondary to the primary. The primary is billed first and we're billed 2nd.
[CUSTOMER][NEUTRAL] And your bill 2, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Got you. OK, and we don't need, we don't need authorization, right?
[AGENT][NEUTRAL] No, ma'am, because it's not the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you OK.
[CUSTOMER][NEUTRAL] OK great alrighty [PII] first initial of your last name please.
[AGENT][NEUTRAL] Yes, ma'am. It's A.
[CUSTOMER][POSITIVE] Alrighty, OK, that'll do it thank you so much for your time, [PII]. I appreciate it.
[AGENT][POSITIVE] You're very welcome. I hope you have a great rest of your week, Ms. [PII]. Thanks for calling APL.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][NEUTRAL] Mm bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Mm bye bye.