AccountId: 011433970860
ContactId: 42bd2ed1-69a7-4439-9fe7-a34568ed8818
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219679 ms
Total Talk Time (AGENT): 121667 ms
Total Talk Time (CUSTOMER): 71480 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/42bd2ed1-69a7-4439-9fe7-a34568ed8818_20250317T15:10_UTC.wav
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[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. This is [PII] calling from Baptist Outpatient Services. I'm calling to check outpatient benefits for a patient.
[AGENT][POSITIVE] Oh, I can certainly help with outpatient benefits. All right. What is that policy number, please?
[CUSTOMER][NEUTRAL] Um, I have 1067782.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], um [PII].
[AGENT][NEUTRAL] OK, thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you. It looks like they had a policy with us from [PII].
[AGENT][NEUTRAL] So it was only active from [PII] until [PII], but there's no uh more current uh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Policy.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] That's weird, she just
[CUSTOMER][NEUTRAL] Advice that should be the same.
[CUSTOMER][NEUTRAL] Um, can you search by name and last name by any chance? Cause maybe they have a different number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, let me make sure that uh I have her name spelled properly. How do you spell the last name again, please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um it's [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I wonder if she has a policy on her own. Um.
[AGENT][NEUTRAL] I think that's what's happened. It looks like that, it had lapsed at one point and she may have a policy on her own. So let's, uh, it looks like uh her correct policy number is 02.
[AGENT][NEUTRAL] 1
[AGENT][NEUTRAL] 00356. So this, uh, it looks like, yeah, it looks like it did lapse and then they and then they renewed it again a couple of years later. That's probably what has happened here. So, so when you send in your claim, yes, yes, it will be that 02100356 that we want to use. Now, is there anything else that I can tell you about this policy?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, yeah.
[CUSTOMER][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] Um, just to confirm if they have any balance available that can cover her co-payments.
[AGENT][NEUTRAL] OK, so the policy um picks up the deductible, co-payment or co-insurance for treatment within the physician's office, but not the office visit co-pay. Um, now, as far as uh the calendar year [PII], this is a per calendar day benefit, so it's gonna renew each and every calendar day. Um, so it's, it's not really a balance, but it's, it'll pick up the treatment within the physician's office but not the office visit co-pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. So, she doesn't have any balance per day. It's just whatever it is, then you guys pick it up.
[AGENT][NEUTRAL] Yeah, so, so each, yeah, each day there's that, uh, there is that, um, benefit, but uh it doesn't cover the office visit copay.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][POSITIVE] OK. Got it. Thank you so much. And can I have again your name? I'm sorry.
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. Is there anything else at all that I may help with?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] That would be all. Thank you so much.
[AGENT][POSITIVE] OK, thanks for contacting AP have a good