AccountId: 011433970860
ContactId: 0b408e1b-b9f5-41c3-a109-38a8641568dc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223369 ms
Total Talk Time (AGENT): 114118 ms
Total Talk Time (CUSTOMER): 62100 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/0b408e1b-b9f5-41c3-a109-38a8641568dc_20250303T21:56_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] Good afternoon, [PII]. My name is [PII], and I'm calling from Baptist Outpatient Services to get benefits for mutual patients.
[AGENT][NEUTRAL] OK, [PII], you only need benefits. You do not need eligibility as well?
[CUSTOMER][NEUTRAL] Uh, no, no, just the benefits, please.
[AGENT][POSITIVE] OK. Yes, ma'am. I can help you with that. And what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Yes, that would be 01996754, M as in Mike, L as in Larry, 8.
[AGENT][NEUTRAL] OK, thank you, one moment please while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you will be a verification of the benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] The patient's last name is, let me attempt to say this, it's [PII] First name is [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you and what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on the supplemental policy that he has with us, his outpatient benefit max per calendar day for covered outpatient services is $500 and there is no outpatient deductible per covered person per calendar day.
[AGENT][NEUTRAL] Because this is a supplemental policy and add to his primary insurance, we will also need to have a copy of his primary insurance company's explanation of benefits sent with the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status and have access to our EOB.
[CUSTOMER][POSITIVE] Perfect. OK.
[AGENT][POSITIVE] And that portal website is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you for that, [PII]. And if I can, can you, are there any any accumulation on that 500?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Well, again, this is a per calendar day.
[CUSTOMER][NEUTRAL] OK, so 500 per day, got it.
[AGENT][NEUTRAL] So yes ma'am, it's not a per year it's a per calendar day so is this for a future data service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Uh yes, yes.
[AGENT][NEUTRAL] Yes, ma'am. So there would not be.
[CUSTOMER][NEUTRAL] OK, can I get a reference number, please?
[AGENT][NEUTRAL] Uh, you would use my name along with today's date.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Thank you so much for help, [PII]. You have a great day.
[AGENT][NEUTRAL] And is there
[AGENT][POSITIVE] Oh, well, you're very welcome. Is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] No, you've been great thank you so much.
[AGENT][POSITIVE] Oh, well, you're very welcome. It was my pleasure and thank you again for calling APL. I hope you have a nice evening.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.