AccountId: 011433970860
ContactId: 031c5a3a-6d0c-4313-99cd-e9df23e963d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268250 ms
Total Talk Time (AGENT): 89010 ms
Total Talk Time (CUSTOMER): 54890 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/031c5a3a-6d0c-4313-99cd-e9df23e963d2_20250612T17:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi. Good afternoon, [PII]. My name is [PII] and I'm calling from Baptist Health Medical Group and I'm calling to verify if a patient has an active policy.
[AGENT][NEUTRAL] I can help you with eligibility. um, can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII]. Sorry.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] That will be 01482796 M as in Mary, L as in Lotus 7.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Oh, I'm sorry. Um, I missed to, uh, mention that this is for a specialist, um, office, uh, service.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I can look that up for you. Um, can I get you to verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Sure. It's [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm showing that this policy is active with an effective date of [PII].
[AGENT][NEUTRAL] This is secondary gap insurance, so we will need the primary EOB when filing a claim uh for this policy, and let me pull up their policy certificate and see about specialist visits.
[AGENT][NEUTRAL] Alright, give me just one moment.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] And you said it's for a specialist, is it correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] Right, and this is just a verification of coverage, not a guarantee of payment. It looks like they have an outpatient benefit maximum of up to $500 per calendar day.
[AGENT][NEUTRAL] With a $0 deductible?
[AGENT][NEUTRAL] Let me see a specialist visits.
[CUSTOMER][NEUTRAL] OK, but does it cover office visits, uh, yeah.
[AGENT][NEUTRAL] OK, so you just wanted the office visit. Um, we don't cover the office visit fee, but we do have, there is an office treatment writer, but not the visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and can I have a reference number for this call?
[AGENT][NEUTRAL] Sure, so we don't have reference numbers, but you can use my name and last initial in today's date. So [PII] in today's date.
[CUSTOMER][POSITIVE] OK, great. Thank you.
[AGENT][POSITIVE] OK, thank you for calling APL, and I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][NEUTRAL] Alright, bye.