AccountId: 011433970860
ContactId: 64fab97a-2bbe-423b-b429-ab32fda98f66
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306950 ms
Total Talk Time (AGENT): 151933 ms
Total Talk Time (CUSTOMER): 50784 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/64fab97a-2bbe-423b-b429-ab32fda98f66_20250513T13:10_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 is [PII]. I'm calling from Baptist Outpatient Services to see the outpatient benefits from.
[AGENT][NEUTRAL] OK, I see you're needing, do you also need eligibility or do you strictly just need benefits?
[CUSTOMER][POSITIVE] Just some outpatient benefits.
[AGENT][POSITIVE] Yes, I can help you with that and what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][POSITIVE] Thank you. And how do you spell your first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] member's policy number is 016786771.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] And your list so any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. His date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so first off, Elysis, I need to give you a different policy number because you gave me an old policy number that's no longer active. The policy number you gave me termed as of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the current active policy that also went into effect that same day, [PII].
[AGENT][NEUTRAL] Is policy 024620.
[AGENT][NEUTRAL] 34.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Give me a moment to get your benefit information pulled up and you said that you were needing outpatient benefit max, is that correct?
[AGENT][NEUTRAL] For outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so he has an outpatient benefit on this supplemental policy, the outpatient benefit maximum per calendar day for covered outpatient services is $1000.
[AGENT][NEUTRAL] And there is no outpatient deductible per cover person per calendar day.
[AGENT][NEUTRAL] If there is a way that you can make a note of the next two things that I'm gonna give you, uh, first off, because this is a supplemental policy to his primary insurance, when the claim is submitted to APL, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[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 the website for our portal is located at secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's $1000 per calendar day.
[AGENT][NEUTRAL] Uh-huh, for covered outpatient services, yes sir, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, thank you, um, so much for your help today, [PII]. Can I have the initial to your last name and a reference number for this call?
[AGENT][POSITIVE] Well, you're welcome.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] The initial to my last name is [PII], and my name along with today's date will be your call reference number.
[CUSTOMER][POSITIVE] OK, thank you for your help.
[AGENT][POSITIVE] Well, you're very welcome and again thank you for calling APL. I hope you have a great day if that is all I can help you with today.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. Bye bye.