AccountId: 011433970860
ContactId: 3de3dcdc-ff6c-4d55-968e-971740dcaef2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217289 ms
Total Talk Time (AGENT): 107851 ms
Total Talk Time (CUSTOMER): 61640 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=2.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/3de3dcdc-ff6c-4d55-968e-971740dcaef2_20250312T13:50_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] from Baptist Hospital. I'm calling to see if you can help me with the member's benefits, please.
[AGENT][NEUTRAL] OK, [PII], you do not need eligibility. You only need benefit information, is that correct?
[CUSTOMER][NEUTRAL] Please.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] It's gonna be 01893411.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 8.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] OK, so it's [PII] Last name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so she is the subscriber on this limited excuse me, on this supplemental policy, and what type of benefit information do you need inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] It's outpatient.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so in this supplemental policy her outpatient benefit maximum per calendar year for covered outpatient services is $500 and there is no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, hold on.
[AGENT][NEUTRAL] And because this is a supplemental policy, [PII], to her primary insurance, when the claim is submitted to APL for review, we will also need to receive a copy of her primary insurance.
[AGENT][NEUTRAL] Explanation of benefits and then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status for us by going to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. OK, so I'll list that. And um no others required, correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That is correct. No prior authorization to the supplemental policy is required.
[CUSTOMER][NEUTRAL] Alright [PII].
[CUSTOMER][POSITIVE] Perfect. OK, [PII], may I have a reference number?
[AGENT][NEUTRAL] Yes, you would use my name along with today's date.
[CUSTOMER][POSITIVE] Perfect. All [PII]. Um, no.
[AGENT][NEUTRAL] OK. Any, anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it thank you so much for your time.
[AGENT][POSITIVE] Well, you are certainly very welcome and thank you for calling APL. I hope you have a wonderful day, [PII].
[CUSTOMER][POSITIVE] You too. You take care.
[AGENT][POSITIVE] Thank you and you as well.
[CUSTOMER][POSITIVE] OK thanks.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] OK.