AccountId: 011433970860
ContactId: fded2952-706d-4abe-be75-805afd4c8458
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228979 ms
Total Talk Time (AGENT): 82478 ms
Total Talk Time (CUSTOMER): 50232 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/fded2952-706d-4abe-be75-805afd4c8458_20250506T15:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Nicholas Children's Cardiology. I need to verify eligibility on a patient.
[AGENT][NEUTRAL] OK, I can help you with eligibility. May I please get your name and your callback number?
[CUSTOMER][NEUTRAL] [PII] and my number is [PII].
[AGENT][NEUTRAL] Thank you Miss [PII] and what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Pediatric Specialists of America.
[AGENT][NEUTRAL] OK, and can I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII] and it's 02608019.
[AGENT][NEUTRAL] OK, let me look her up real quick.
[AGENT][NEUTRAL] Alright, I do show that [PII] does have an active policy with us, and the effective date of the policy for her is [PII] and everything's current and active at this time.
[CUSTOMER][NEUTRAL] OK, I have a quick question. For office visits to the cardiologist, she's got a $75 co-pay for specialist visit. Is that something you pick up or she's responsible for?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, let me look real quick and see if office visits are covered under her policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's gonna be just a second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] I'll need to pull in the policy certificate so that I can read it and see.
[AGENT][NEUTRAL] Uh, let's
[AGENT][NEUTRAL] Office visits are covered under this policy, so it goes um by the benefit amount and this is just to verify her benefits. It's not a guarantee of payment. She has an outpatient benefit amount per calendar year of $5000 that goes towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, so it, so it's not something that she needs to pay then, right?
[AGENT][NEUTRAL] Correct, that's something that can be claimed.
[CUSTOMER][POSITIVE] OK perfect I'll I'll wipe that out then all right thank you so much you have a great day.
[AGENT][POSITIVE] You have a wonderful day too, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. You take care.
[CUSTOMER][NEUTRAL] Alright you too bye.