AccountId: 011433970860
ContactId: 04a8ea8d-a6cc-4dbe-a4da-e13a82d03e5e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298589 ms
Total Talk Time (AGENT): 121036 ms
Total Talk Time (CUSTOMER): 105460 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/04a8ea8d-a6cc-4dbe-a4da-e13a82d03e5e_20250528T16:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good afternoon, [PII]. My name is [PII], and I'm calling from Baptist Hospital. I was wondering if you can assist me with the patient. I just wanted to verify if he's active with you.
[AGENT][NEUTRAL] OK, I can help you with eligibility, uh, [PII], can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, of course. [PII].
[CUSTOMER][NEUTRAL] And my extension is [PII].
[AGENT][NEUTRAL] OK, um, do you have a policy number with you?
[CUSTOMER][NEUTRAL] Uh, yes, I do. Allow me one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do apologize. I thought I was ready for you. Um, it is 0, thank you. 0224045, I'm sorry, 465.
[AGENT][POSITIVE] It's OK. Take your time.
[CUSTOMER][NEUTRAL] And then I'm showing M as in Mary, L as in Larry, number 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me just a moment to look that up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] and date of birth I'm showing [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, this is a Medlink policy, uh, so it is secondary gap insurance. The primary will need to pay benefits before filing a claim through this policy.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] This policy has an effective date of [PII] and it is active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. And may I ask, um, that he has a coverage, correct?
[AGENT][NEUTRAL] Yes, and it is a medlink policy. So whenever you file a claim, uh, for this policy, we will need the primary insurance EOB or explanation of benefits uh with with the claim documents, um, because if they deny the claim this claim won't pick up after it.
[AGENT][NEUTRAL] Uh, it has to show that the primary paid certain benefits first. Mhm.
[CUSTOMER][NEUTRAL] Oh, I see.
[AGENT][NEUTRAL] Were there any benefits in, in particular you wanted to know about?
[CUSTOMER][POSITIVE] Ah, perfect, perfect.
[CUSTOMER][NEGATIVE] Actually, no, no benefits. All I need is um how much is their coverage and how much have they used so far.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like and this is a guarantee uh this is a verification of benefits and not a guarantee of payment looks like they have um an inpatient benefit.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Of up to $7900 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] With a $0 deductible.
[AGENT][POSITIVE] They have an outpatient benefit. I'm sorry?
[CUSTOMER][NEUTRAL] 0, OK, that.
[CUSTOMER][POSITIVE] Yes. No, no, no, that's what I was gonna ask you. Thank you.
[AGENT][NEUTRAL] Yeah, the outpatient benefit maximum is the same, $7900 per calendar year with a $0 deductible that includes ER visits with a $0 deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And how much have they, have they used so far? 0, you said?
[AGENT][NEUTRAL] And let me check on that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] I'm not showing any benefits being used to date.
[CUSTOMER][NEUTRAL] Oh, OK, perfect. Um, also, may I have the spelling of your name as well, please?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Last initial [PII].
[CUSTOMER][NEUTRAL] S in hospitals. Perfect. Now, may I ask, can I use your name as reference or would you happen to have a reference number for me for this call?
[AGENT][NEUTRAL] So the reference uh you'll use is my name and last initial in today's date.
[CUSTOMER][POSITIVE] And perfect. Thank you so very much for your help. I really appreciate it.
[AGENT][POSITIVE] OK well thank you for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] You as well. Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye.