AccountId: 011433970860
ContactId: 3b6d8f42-9308-4f83-ae60-71e3bbc1b592
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229119 ms
Total Talk Time (AGENT): 104660 ms
Total Talk Time (CUSTOMER): 102648 ms
Interruptions: 5
Overall Sentiment: AGENT=1.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/3b6d8f42-9308-4f83-ae60-71e3bbc1b592_20250307T13:10_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] Well
[CUSTOMER][NEUTRAL] Hi, good morning. This is [PII] calling from Baptist Health Medical Plaza in [PII]. We have a mutual patient who is a member of yours, and she has provided her gap insurance card. I just wanted to verify that she has available funds to be used for diagnostic imaging in an outpatient facility.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], so you're needing to verify eligibility and benefits for a member, is that correct? Yes, ma'am, I can help you. And what is a good callback number for you please, [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] I need to get our payment, yeah. I need to get their payments. Sorry, I'm sorry, ma'am?
[AGENT][NEUTRAL] The patient's policy number?
[CUSTOMER][NEUTRAL] Um, the policy number is 02585906ML7.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][POSITIVE] [PII] OK thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Quando estalista to confirm primera a top swipe cuaquera.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] If they can if they ever.
[CUSTOMER][NEUTRAL] It's the total, uh huh.
[CUSTOMER][NEUTRAL] Um, see what your order, OK.
[AGENT][NEUTRAL] OK, so any information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Um, her name is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So I do show she is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the outpatient benefit max per calendar year for covered outpatient services is 6600.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] What.
[AGENT][NEUTRAL] Again, the outpatient limit is 6600 and there is no outpatient deductible per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and she has um the 6600 remaining.
[AGENT][POSITIVE] I can check that for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Whose?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I don't bo all the oil that quarantine no.
[AGENT][NEUTRAL] And yes ma'am, as of now she has not used any of her benefits for this calendar year. Now because this policy is a supplemental policy, [PII], to our primary, when the claim is submitted to APO we will also have to have a copy of her primary insurance company's explanation of benefits.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal that you should be able to check our claim status in and our website for that is secured.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, OK, perfect, thank you so much for the information. I hope you have a great day.
[AGENT][POSITIVE] Well you I hope you do too. Is there anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] No, you have been very helpful thank you I hope you have a good weekend.
[AGENT][POSITIVE] Well, it was my pleasure. Yes, ma'am, you too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye