AccountId: 011433970860
ContactId: 0bc594ab-4f68-4f74-83f8-df812e729344
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198639 ms
Total Talk Time (AGENT): 68891 ms
Total Talk Time (CUSTOMER): 69549 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/0bc594ab-4f68-4f74-83f8-df812e729344_20250514T20:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII] calling with Baptist referral department. I'm calling to verify members, uh, eligibility, please.
[AGENT][NEUTRAL] OK, I verify eligibility for you and your name is again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, spell that for me.
[CUSTOMER][NEGATIVE] [PII].
[AGENT][NEUTRAL] OK, and the policy number, please?
[CUSTOMER][NEUTRAL] 02502524 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm and I'm sorry I didn't catch your name when you first got on the line it cut out.
[AGENT][NEUTRAL] Uh, it's [PII] last initial [PII]
[CUSTOMER][POSITIVE] Perfect. Thank you, [PII].
[AGENT][NEUTRAL] And Ms. [PII], do you have, uh, you're welcome. Do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Is [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Showing her effective date is [PII] and she is active on the policy.
[CUSTOMER][NEUTRAL] OK, do you guys cover any of her primary insurance?
[CUSTOMER][NEUTRAL] Like, um, like co-pay or anything like that deductible.
[AGENT][NEUTRAL] Uh, yes, with this being a secondary policy, it helps with primary insurance deductible, co-pay, or co-insurance, either for outpatient or in hospital.
[CUSTOMER][NEUTRAL] Does it cover 100% or is the patient responsible for anything on the secondary end?
[AGENT][POSITIVE] Well, they do have a max benefit. Once that benefit has been maxed then anything after primary will be patient responsibility.
[CUSTOMER][NEUTRAL] What's the max benefit?
[AGENT][NEUTRAL] For it for outpatient or in hospital?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, not a guarantee of payment, just verification of coverage. Patient has a benefit max up to 2500 per calendar year.
[CUSTOMER][NEUTRAL] Per calendar year OK.
[CUSTOMER][NEUTRAL] Um, have they met any of their, um, uh, their, their
[CUSTOMER][NEUTRAL] Of that, the out of pocket, the 2500.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] How they met any of that max benefit excuse me?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, no, ma'am. Don't show she's used any of her benefits for this year.
[CUSTOMER][NEUTRAL] Nothing. OK, perfect. Is there a reference number for our call?
[AGENT][NEUTRAL] Uh, you may use my name in today's date.
[CUSTOMER][POSITIVE] Alrighty. Thank you so much for your time. I hope you have a wonderful night.
[AGENT][POSITIVE] Alright, you too, Ms. [PII], thanks for calling APL bye.
[CUSTOMER][POSITIVE] Thank you bye bye.