AccountId: 011433970860
ContactId: 27b3ed09-e86d-440a-890a-3c3dc741f8f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291350 ms
Total Talk Time (AGENT): 120458 ms
Total Talk Time (CUSTOMER): 109505 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=2.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/27b3ed09-e86d-440a-890a-3c3dc741f8f3_20250602T21:15_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, this is [PII] calling from Baptist Outpatient Services, um, about a mutual client. I just wanted to see if I can verify her benefits for an outpatient free standing.
[AGENT][POSITIVE] OK, I can help you with benefits. Um, may I, can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Of course, give me just one moment. It's gonna be [PII] and that's gonna be a direct line.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] It's gonna be 01749249.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, and 8.
[AGENT][NEUTRAL] OK, um, give me just one moment to pull that up.
[CUSTOMER][POSITIVE] Of course thank you so much.
[AGENT][NEUTRAL] And can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Of course it's gonna be [PII], and then her birthday is um [PII].
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][POSITIVE] Yeah, no problem.
[AGENT][NEUTRAL] And is this for a service that she's coming in for?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the only reason I ask is because that policy number has lapsed and so I'm going to go ahead and give you the new policy number um because you will need that when filing a claim.
[CUSTOMER][POSITIVE] Oh thank you so much.
[AGENT][NEUTRAL] Alright, and let me know when you're ready and I can give it to you. OK, it's 02.
[CUSTOMER][POSITIVE] Alright, I'm ready for you.
[CUSTOMER][POSITIVE] I'm ready for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 02504901.
[CUSTOMER][POSITIVE] Perfect. That's her policy number. Does she have a group number or anything that we should be um taking into account?
[AGENT][NEUTRAL] Um, it should have stayed the same if it's on there. Uh, the group number will be 20075.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect, it stayed the same.
[AGENT][NEUTRAL] OK, yeah.
[CUSTOMER][POSITIVE] Wonderful, alright, and I'll go ahead and update that as soon as we get off the call.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I am showing that that policy is active as of [PII] and you are wanting outpatient services, correct?
[CUSTOMER][POSITIVE] Free standing benefits, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment while I look that up.
[CUSTOMER][POSITIVE] Yeah no problem thank you for your help.
[AGENT][NEUTRAL] And it sounds like you've done this before, but just to verify, this is secondary gap insurance. It will help pay for co-insurance, co-pay, and co-deductible. But when filing for a claim under this policy, we will need the primary insurance, EOB whenever filing the claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I just wanna go ahead and let you know that, OK.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] And this is just a verification of benefits, not a guarantee of coverage. She has an outpatient benefit maximum of up to $6000 per calendar year, uh, with a $0 outpatient deductible and $0 emergency room deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so she would be able to use those benefits right off the bat.
[AGENT][NEUTRAL] And I'm sorry, did you say it was?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] So those are good.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And she hasn't used any of that um this year?
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] It looks like to date she hasn't used any of those, any of that amount yet.
[CUSTOMER][POSITIVE] OK, wonderful. All right, perfect. May I have your name, if possible?
[AGENT][NEUTRAL] OK. Um, my name is [PII].
[CUSTOMER][NEUTRAL] Perfect and may I have a reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers, but you can use my name and last initial and today's date.
[CUSTOMER][POSITIVE] Perfect. All right, wonderful. Well, I guess that's all my questions for today. Well thank you so much and I hope you have an amazing rest of your day.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.