AccountId: 011433970860
ContactId: fea2928f-fa2d-4c0d-ac3d-29866b0f0d25
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221399 ms
Total Talk Time (AGENT): 95411 ms
Total Talk Time (CUSTOMER): 79395 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/fea2928f-fa2d-4c0d-ac3d-29866b0f0d25_20250311T16:22_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. Um, I'm calling to inquire about a mutual patient. Um, I wanna confirm if coverage is active as well as if he has any deductible out of pocket or co insurance or co-pay.
[AGENT][NEUTRAL] OK, I can verify eligibility and benefits for you and your name is?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from AdventHealth Orlando.
[AGENT][NEUTRAL] OK, and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Uh, sure. It's going to be 01813059 ML 8.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Uh, [PII] Last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK. Uh, give me a moment. Well, I show this policy term [PII]. Give me one moment to see if they have any active coverage.
[AGENT][NEUTRAL] OK, and I do show an active policy. So when you're ready, I can give you that policy number.
[CUSTOMER][NEUTRAL] OK, sure. What is it?
[AGENT][NEUTRAL] OK, it's 2549492.
[CUSTOMER][POSITIVE] OK, OK, got it, thank you so much.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] You're welcome. And their effective date is [PII]. Policy is active. And what benefits were you needing for this patient?
[CUSTOMER][NEUTRAL] Uh, does he have a deductible out of pocket?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] For outpatient in hospital.
[CUSTOMER][NEUTRAL] A hospital outpatient?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, no, ma'am, I don't show a deductible on this plan.
[CUSTOMER][NEUTRAL] OK. How about an out of uh out of pocket?
[AGENT][NEUTRAL] Uh, not a guarantee of payment, just a verification of coverage. Uh, for outpatient, I show the patient has a benefit max up to $6000 per calendar year.
[CUSTOMER][NEUTRAL] OK, and does he have a remaining balance at this point?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Oh, yes, I don't sure he's used any of his, uh, outpatient benefits, so it is available.
[CUSTOMER][NEUTRAL] OK, so he, he still has 6000 remaining?
[AGENT][NEUTRAL] For outpatient, yes.
[CUSTOMER][NEUTRAL] OK. OK. And by any chance, does he have like a co-insurance or a co-pay?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] This is just a secondary supplemental plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, it's a supplemental? OK, great.
[CUSTOMER][NEUTRAL] OK, uh, great, that was uh the reason for my call, and may I have your name, last initial, and a reference number for this call, please?
[AGENT][NEUTRAL] Uh, we don't give reference numbers, but you may use my name at today's date. Um it's [PII], last initial [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, great. Thank you so much. I do appreciate your help.
[AGENT][POSITIVE] Oh, yes, ma'am. Thank you for calling APM Ms. [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.