AccountId: 011433970860
ContactId: 3d975ac7-ce5b-4395-a40b-117cda22de35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277200 ms
Total Talk Time (AGENT): 130140 ms
Total Talk Time (CUSTOMER): 67270 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/3d975ac7-ce5b-4395-a40b-117cda22de35_20250522T19:52_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling from Baptist Hospital. I just wanted to verify this patient's eligibility and benefits with you, please.
[AGENT][NEUTRAL] OK, [PII], you're needing to verify eligibility and benefits. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and [PII], how do you spell your name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Mhm. Mhm. Mhm.
[AGENT][NEUTRAL] OK, I got it right then. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII] and my extension is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] It's 0222416 M for Mary, L for Larry, and 8.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] OK. So you said it was 0222416. Is that correct?
[CUSTOMER][NEUTRAL] It's 02224116.
[AGENT][NEUTRAL] I think we're missing a number.
[AGENT][POSITIVE] 2 1s, OK, thank you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on the supplemental policy, [PII], and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah it would be for outpatient please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this supplemental policy, his outpatient benefit maximum per calendar year for covered outpatient services is $200.
[AGENT][NEUTRAL] And there is no outpatient deductible for covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, and how much has he used?
[AGENT][NEUTRAL] If you will
[AGENT][NEUTRAL] I can check that.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And as of now for this calendar year, he has used $170 of that benefit.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] And if you all do file a claim for him, [PII], we will have to have a copy of the primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed the claim here at APL we do have a portal in which you should be able to check claim status.
[AGENT][NEUTRAL] And our website for that is located at [PII].
[CUSTOMER][POSITIVE] OK, got it. Thank you.
[AGENT][POSITIVE] OK. You're welcome. And is there anything else that I could help you with today?
[CUSTOMER][NEUTRAL] Um, just a reference number for the call, please.
[AGENT][NEUTRAL] Yes, ma'am, you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK, and may I have the first initial of your last name please?
[AGENT][NEUTRAL] Sure, it is [PII].
[CUSTOMER][POSITIVE] Got it. Well, thank you so much for your help, [PII]. Have a good day.
[AGENT][POSITIVE] Well, I hope you have a great uh rest of your day as well, [PII], and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.