AccountId: 011433970860
ContactId: 41f97084-7256-4b0c-8c90-2681633752c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 289859 ms
Total Talk Time (AGENT): 144029 ms
Total Talk Time (CUSTOMER): 57302 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/41f97084-7256-4b0c-8c90-2681633752c6_20250110T14:30_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] Hi, good morning, [PII]. My name's [PII]. I'm calling from Baptist Outpatient Services, calling to see the outpatient benefits for a member.
[AGENT][NEUTRAL] OK, you say that you're needing outpatient benefits for a member, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Yes, I can help you with that. And could you spell your name for me to make sure I get it correct?
[CUSTOMER][POSITIVE] Yes, yes, of course. [PII]
[AGENT][POSITIVE] Thank you. And your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the mem OK, thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Direct line.
[CUSTOMER][NEUTRAL] The member's policy number is 129611.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK, so we're, that's not a valid number?
[CUSTOMER][NEUTRAL] OK, I'm let me read it again. 1296116 ML 8.
[AGENT][NEGATIVE] We're missing some numbers. Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And any information that I do provide for you today, you lose, you loseses 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] [PII] and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Just one moment please.
[CUSTOMER][POSITIVE] No worries.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on the supplemental policy and it is active with an effective date of [PII], I'm sorry, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And one moment on the benefits, she has an outpatient benefit maximum per calendar year for covered outpatient services of $5000 with no outpatient deductible per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And would you be able to tell me if she's accumulated anything?
[AGENT][NEUTRAL] And you are referring to for this calendar year?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Uh, so let's
[AGENT][NEUTRAL] I can. One moment.
[AGENT][NEUTRAL] OK, so as of now there have not been any benefits used for her for this calendar year?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And because this is a supplemental policy, you lease it to her primary insurance, we will have to have a copy of her primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL you may go to our portal at [PII].
[AGENT][NEUTRAL] To check claim status and have access to the explanation of benefits for us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much for all your help today, [PII] could I have the.
[AGENT][NEUTRAL] Well, you are certain.
[AGENT][NEUTRAL] Oops sorry.
[CUSTOMER][NEUTRAL] Can I have the initial of your last name please and a reference number for this call?
[AGENT][NEUTRAL] Sure, yes, actually my name along with today's date will be your call reference number.
[AGENT][NEUTRAL] And the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much for your help today, [PII].
[AGENT][POSITIVE] Well, you're very welcome, [PII], and if that's all I can help you with, thank you again for calling APL and I hope that you have a wonderful weekend.
[CUSTOMER][POSITIVE] Thank you you as well.
[AGENT][POSITIVE] Uh-huh, thank you very much.
[AGENT][NEUTRAL] Bye bye.