AccountId: 011433970860
ContactId: 142264fa-bffb-4137-b761-898d0a48eb37
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199779 ms
Total Talk Time (AGENT): 102840 ms
Total Talk Time (CUSTOMER): 39596 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/142264fa-bffb-4137-b761-898d0a48eb37_20250312T12:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. I'm calling from Baptist Hospital just to verify if this patient has any outpatient benefits, please.
[AGENT][NEUTRAL] OK. Did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yes, ma'am, and you're wanting to check eligibility and benefits or strictly benefits?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Just benefits.
[AGENT][POSITIVE] Yes ma'am, I can help you with that, and [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] I have 01659400 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] OK, and the information, [PII] that I do provide would be a verification of benefits and not a guarantee of payment. What is your patient's name, place, and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] It would be outpatient.
[AGENT][NEUTRAL] OK, so I, um, on this supplemental policy, her outpatient benefit maximum per calendar year for covered outpatient services is $7900 and there is no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, and what.
[AGENT][NEUTRAL] And uh mhm, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Would you be able to tell me how much um she has available or how much um she's used to that?
[AGENT][NEUTRAL] As of now, uh-huh, she has used, I'm sorry, $7840.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And do you provide a reference number for the call?
[AGENT][NEUTRAL] Yes, ma'am, this, um, you would use my name along with today's date and just a couple of additional things, [PII]. When the claim is submitted to APL for review, we will also have to have a copy of her primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal that you should be able to check claim status in and that portal website is secured. [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much.
[AGENT][POSITIVE] Well, you are certainly welcome. So again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you. Have a wonderful day.
[AGENT][POSITIVE] Well, I hope you have a wonderful day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Bye bye.