AccountId: 011433970860
ContactId: 4a29f85a-c869-4dac-8181-b3e44407617f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166880 ms
Total Talk Time (AGENT): 79241 ms
Total Talk Time (CUSTOMER): 72838 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/4a29f85a-c869-4dac-8181-b3e44407617f_20250203T21:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Baptist Hospital of Miami, and I'm not sure what kind of policy this is, so I don't know if you're the correct person I need to speak to.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, could I get a good callback number?
[CUSTOMER][NEUTRAL] Of course my direct line is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number. Um, that will be the outpatient certificate number on the card.
[CUSTOMER][NEUTRAL] OK, so that's another question at hand because there's 2 different numbers here. I'm not looking at an actual card. I'm looking at what was entered previously in our system and there's 2 different numbers.
[CUSTOMER][NEUTRAL] Uh, I guess I could just give you the first one.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Alright, it's 02189716 ML 8.
[AGENT][NEUTRAL] OK, and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK. Yes, ma'am. That's it, that's her policy number.
[CUSTOMER][NEUTRAL] So that is the active one. So I'm gonna make a note here that this one is not.
[AGENT][NEUTRAL] And
[CUSTOMER][NEGATIVE] Not this number OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active, and is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, for outpatient under this policy, we cover up to $4000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim. So this is a policy for secondary gap insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Gotcha. And can you see if any of, uh, any has been used out of those 4000 so far?
[AGENT][NEUTRAL] OK. No, ma'am. She's, right, she hasn't used any so far this year.
[CUSTOMER][NEUTRAL] It's early in the year.
[CUSTOMER][POSITIVE] Gotcha. Perfect. All right, and if I could just get the spelling of your first name? I'm sorry.
[AGENT][NEUTRAL] Um, it's [PII], and you can use my name and today's date for the reference number.
[CUSTOMER][POSITIVE] Perfect. Thank you so much for your help. You have a wonderful afternoon.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No ma'am, that was it.
[AGENT][POSITIVE] OK. Thank you again, [PII], for calling APL. You have a great rest of your day as well. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye bye.