AccountId: 011433970860
ContactId: 3d556be6-86d5-4108-b3bf-a8e5d43c55e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214160 ms
Total Talk Time (AGENT): 82225 ms
Total Talk Time (CUSTOMER): 95687 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/3d556be6-86d5-4108-b3bf-a8e5d43c55e8_20250219T13:19_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Baptist Health on a recorded line. How are you doing this morning?
[AGENT][NEUTRAL] I'm doing fine. How are you? Did you say your name was [PII]?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] [PII], OK. And do you have a phone number on yet in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Um, call back is [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] I don't have this.
[CUSTOMER][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I guess we will use outpatient benefit number. It's 02472355ML and the number 8.
[AGENT][NEUTRAL] And what's that patient's name?
[CUSTOMER][NEUTRAL] Um, first name is [PII], last name [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Were you needing claim status or benefits?
[CUSTOMER][NEUTRAL] Um, benefits, I was checking to verify the patient was still active and to see, um, they're coming in for um a TEE. So I was trying to see if that would be covered.
[AGENT][NEUTRAL] OK. Is it for outpatient, doctor's office, or?
[CUSTOMER][NEUTRAL] It's outpatient.
[AGENT][NEUTRAL] That's me, it's gonna be coded as a 22 outpatient.
[CUSTOMER][NEUTRAL] Yes, mhm. [PII].
[AGENT][NEUTRAL] OK, I can give you those benefits. The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment. This policy coordinates with the primary insurance.
[AGENT][NEUTRAL] Whatever the primary applies to their deductible, co-pay or co-insurance will pay up to $250 per occurrence.
[CUSTOMER][NEUTRAL] OK, wait, can you repeat that? What did you say there?
[AGENT][NEUTRAL] We'll pay up to $250 per occurrence.
[CUSTOMER][NEUTRAL] You said $250.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so we'll pay up to $200 per occurrence, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Whatever is applied to the deductible, co-pay or co-insurance from the primary.
[CUSTOMER][NEUTRAL] From the primary, OK.
[CUSTOMER][NEUTRAL] And is there any authorization required?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] No. And then, um, would they be covered for um the TEE echo?
[AGENT][NEUTRAL] If it's done in the outpatient facility, yes, ma'am.
[CUSTOMER][NEUTRAL] It was done in.
[CUSTOMER][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] If it's done in a doctor's office, it would not be.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The American public.
[CUSTOMER][NEUTRAL] And then, um,
[CUSTOMER][NEUTRAL] Is there a reference number for the call?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Is there anything else
[CUSTOMER][POSITIVE] Um, no, [PII], that's all that I needed. Thank you for your assistance today.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] All right, you too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.