AccountId: 011433970860
ContactId: 01e9f394-5271-486d-9658-76f4b94f7127
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251199 ms
Total Talk Time (AGENT): 109830 ms
Total Talk Time (CUSTOMER): 52497 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/01e9f394-5271-486d-9658-76f4b94f7127_20250617T19:28_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII]. I'm calling from Baptist Outpatient Services regarding a mutual patient to obtain outpatient benefits of this year.
[AGENT][NEUTRAL] OK. [PII] you're needing, do you also need eligibility or do you already have that?
[CUSTOMER][NEUTRAL] Uh, I would also need eligibility.
[AGENT][POSITIVE] Yes ma'am, I can help you with that, and [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII], it'll be a direct line.
[AGENT][POSITIVE] Thank you and the member's policy number.
[CUSTOMER][NEUTRAL] That would be.
[CUSTOMER][NEUTRAL] 02464978 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK, so I do say she is a subscriber, [PII], on this supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And you said that you were needing inpatient, outpatient or office benefits.
[CUSTOMER][NEUTRAL] I would need uh outpatient benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the outpatient benefit maximum per calendar year for covered outpatient services is $2500 per covered person with no outpatient deductible for cover person per calendar year.
[CUSTOMER][NEUTRAL] OK, perfect. And has the patient meant anything towards that 2500 this year?
[AGENT][NEUTRAL] I can check.
[AGENT][NEUTRAL] As of now, she has used $80.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK perfect thank you so much for that information.
[AGENT][NEUTRAL] And then because, yes ma'am, you're welcome and because this is a supplemental policy to the primary insurance, Gladys, when the claim is submitted to us for review, we will also have to receive a copy of a primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we've processed our claim here at APL we do have a portal that you all should be able to check her status in.
[AGENT][NEUTRAL] By going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, thank you so much for that information, [PII].
[AGENT][POSITIVE] Oh, you're welcome. Yes I am. And is there anything else, [PII] I can help you with?
[CUSTOMER][NEUTRAL] Um, no, that would be all for today. If you may just provide me a last name initial, and a reference number towards this call.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] [PII] and my name in today's date will be your call reference number.
[CUSTOMER][POSITIVE] Alrighty perfect thank you so much [PII] again I hope you have a great rest of your day today.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, I hope you do too, Gladys, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye bye now.
[AGENT][NEUTRAL] Bye-bye.