AccountId: 011433970860
ContactId: fc82a1f5-0e9b-42cf-a137-76539248e826
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205520 ms
Total Talk Time (AGENT): 92748 ms
Total Talk Time (CUSTOMER): 65390 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/fc82a1f5-0e9b-42cf-a137-76539248e826_20250610T15:50_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], my name is [PII]. I'm calling from Coral Gables Hospital. I have a patient that is scheduled on [PII] to come in for an outpatient surgery. I'm trying to verify their eligibility and benefits. I show your plan as secondary.
[AGENT][POSITIVE] OK, well, I can definitely help you with the eligibility and benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, [PII], sorry, [PII] and then I have a policy of 021-897-09 M like Mary, L like Larry, 8.
[AGENT][NEUTRAL] Mhm.
[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] [PII] and I have a date of birth of [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Now, this particular policy is no longer active, um, but they do have an active policy. So the policy number you gave me was effective from [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the active policy number is 229.
[AGENT][NEUTRAL] 5975.
[AGENT][NEUTRAL] And this policy has been effective since [PII].
[AGENT][NEUTRAL] And let me pull that up so I can get to the benefits. Um, the letters is just for the card, um, for calling and claims, you just need the numbers.
[CUSTOMER][NEUTRAL] OK, it doesn't have any letters at the end or anything?
[CUSTOMER][NEUTRAL] Oh, OK, so
[CUSTOMER][POSITIVE] OK, no worries
[AGENT][NEUTRAL] And then, um, what type of benefits did you want to go over?
[CUSTOMER][NEUTRAL] He's coming in for an outpatient surgery for a hip surgery, and I show as you being secondary to his Florida Blue.
[AGENT][NEUTRAL] Yes, so for outpatient, we will pay up to $3500 per calendar year. Did you want me to see if he's used any for this year?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So he's used $200.49. Um, he has $3,299.51 left for the year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect alrighty.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Would they require an authorization since they're secondary or no?
[AGENT][NEUTRAL] No, we don't require any prior author or pre-cert.
[CUSTOMER][NEUTRAL] Uh, what is the initial to your last name?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And is there a reference number for the phone call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] All right, perfect. Thank you.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that is it. You have a good day.
[AGENT][POSITIVE] You also, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.