AccountId: 011433970860
ContactId: fc1343da-7879-4a47-bf47-c386bef20b26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170550 ms
Total Talk Time (AGENT): 88818 ms
Total Talk Time (CUSTOMER): 59472 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/fc1343da-7879-4a47-bf47-c386bef20b26_20250528T14:50_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]. My name is [PII] from Jackson Memorial Hospital. I'm trying to verify, um,
[CUSTOMER][NEUTRAL] Eli eligibility.
[AGENT][NEUTRAL] Yeah, I can check eligibility for you. Sure, uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] On a patient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] It is, she told me there was one for outpatient and one for inpatient. Um, the one I have here, since it's an outpatient surgery, it's 01845863 ML 8.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying all of that. Uh, so this policy is active. The effective date was [PII].
[AGENT][NEUTRAL] And this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] OK, is there a specific amount that she has for the year and has she used it?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure, and this was for outpatient you said?
[CUSTOMER][NEUTRAL] Yes, it's for an outpatient uh for tomorrow actually.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims so that outpatient benefit is $1000 per calendar year and if you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, none of that benefit has been used so far this year.
[CUSTOMER][NEUTRAL] Not used, OK, and what is the correct billing address?
[AGENT][NEUTRAL] So that is uh [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that was in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I've also got a fax number and a payer ID if you'd like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what's the payer ID?
[AGENT][NEUTRAL] That is 60801.
[CUSTOMER][NEUTRAL] Can you repeat it one more time please?
[AGENT][NEUTRAL] Sure, 60801.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] That's basically it. Thank you very much, ma'am.
[AGENT][POSITIVE] Of course, thanks for calling APL. Have a great rest of your day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.