AccountId: 011433970860
ContactId: 0233fab6-09f7-4165-9bbd-3348d196569b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274720 ms
Total Talk Time (AGENT): 114013 ms
Total Talk Time (CUSTOMER): 134393 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/0233fab6-09f7-4165-9bbd-3348d196569b_20250304T16:44_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]. Last name initial [PII]. I'm calling from the facility Baptist Medical on a recorded line. I just need to confirm that patient has active coverage and also just to confirm if we're a network.
[AGENT][NEUTRAL] OK, I can help you, Miss [PII] with um eligibility and network information. Uh what is your callback number please ma'am just in case our call is disconnected.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure that is [PII] option 3.
[AGENT][NEUTRAL] Thank you, ma'am. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, his name is [PII]. Last name is [PII], and that's date of birth [PII].
[AGENT][NEUTRAL] OK, and do you have his policy number?
[CUSTOMER][NEUTRAL] Oh, I'm sorry you did ask for that it's
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] It's, it's been a long day already, um, it is 02.
[AGENT][NEUTRAL] Uh right.
[CUSTOMER][NEUTRAL] It's 02584195.
[AGENT][NEUTRAL] OK, let me look him up real quick for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. His date is [PII], and um there's no network because this is not the primary insurance. This is a supplemental insurance.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, OK, I I thought that, but I, you know, this is my first time calling you guys so I wasn't sure how that works so it doesn't matter if we're in network or not because it's secondary. OK, um, the other question is do you guys check to see if um uh like a CPT code is covered or is that the same thing? It's gotta go through the primary then to you guys.
[AGENT][NEUTRAL] Oh yeah, yeah.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] For outpatient surgery.
[AGENT][NEUTRAL] It, it was the primary and then to us and um this is just to verify his benefits. It's not a guaree of payment. What this policy is is it's a supplemental insurance that helps with deductible, co-pay, and co-insurance. Um, it's a calendar year benefit dollar amount per calendar year.
[CUSTOMER][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] So if he goes inpatient, he has a benefit of $4000 per calendar year.
[AGENT][NEUTRAL] And then for outpatient he has a per calendar.
[AGENT][NEUTRAL] $500 to help towards coy coinsurance or uh deductible.
[CUSTOMER][NEUTRAL] OK, so 500 for outpatient.
[CUSTOMER][NEUTRAL] I wanna make sure I heard that right. I'm sorry the phone keeps breaking up.
[AGENT][NEUTRAL] Yes, calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I know I heard that too, yeah, per calendar day $500.
[CUSTOMER][NEUTRAL] Per
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For outpatient, OK.
[CUSTOMER][NEUTRAL] Go through.
[CUSTOMER][NEUTRAL] OK, I think I got it all in here. I just wanna make sure that there's nothing else I need to do on my end. I just need to make sure that he had active coverage, which I did and you said he was good from [PII] to now, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then uh for outpatients uh $5 500 dollars $500 per calendar day for outpatient procedures, but we are billing through primary first, OK.
[CUSTOMER][NEUTRAL] I just wanna make sure.
[AGENT][POSITIVE] Correct. You've got it.
[CUSTOMER][POSITIVE] Awesome and you said [PII] and I'm sorry I didn't catch your last name initial.
[AGENT][NEUTRAL] A
[CUSTOMER][POSITIVE] OK. Thank you so much and I'm sorry the phone keeps messing up, um, but I think that's all I needed. I appreciate all your help.
[AGENT][POSITIVE] OK, you're very welcome Miss [PII]. I hope you have a good rest of your day and thank you for calling APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Same to you thank you.
[AGENT][NEUTRAL] Mm bye-bye,