AccountId: 011433970860
ContactId: 2ad880b3-9229-477d-b871-de1102728646
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168100 ms
Total Talk Time (AGENT): 100942 ms
Total Talk Time (CUSTOMER): 62108 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/2ad880b3-9229-477d-b871-de1102728646_20250214T19:10_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. Uh, good afternoon. I'm calling from Baptist Hospital and I need to verify this, uh, gap insurance on the patient to see if it's active and what will be the benefit for hospital outpatient services.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Outpatient, OK, yeah, I can check the eligibility and benefits for you. Um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Got it, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, 1216026.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the patient?
[CUSTOMER][NEUTRAL] It's [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. So this policy actually terminated [PII]. If you'll give me one moment, I'll see if they have one that's active, might just be a different policy number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, they do have another one that's active uh let me know when you're ready I can give you this updated policy number.
[CUSTOMER][POSITIVE] Yeah, yeah, I'm ready.
[AGENT][NEUTRAL] OK, it is 0194.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 753 1.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 31. OK.
[AGENT][NEUTRAL] Yes, OK, so this one.
[CUSTOMER][NEUTRAL] Uh, that's the policy number, uh-huh.
[AGENT][NEUTRAL] Correct, um, so this one is currently active, uh, the effective date was [PII], and so this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays and of course I will let you know verification of coverage is not a guarantee of payment for claims. Their outpatient benefit is $5000 max per calendar year and if you'll give me one moment I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hold on. I'm on the phone, I'll be right there.
[AGENT][NEUTRAL] OK, and this was for [PII] correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so so far this year [PII] has used $133.23 of that benefit.
[CUSTOMER][POSITIVE] Perfect. OK. Can I have your name and a reference number for this phone call, please?
[AGENT][NEUTRAL] Yes, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] And was there anything else I could help you with [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No, that will be all. Thank you very much for your help. Have a great afternoon. Bye bye-bye.
[AGENT][POSITIVE] OK, yeah, thanks for calling APL you too bye bye.