AccountId: 011433970860
ContactId: 65b175c0-98bf-4947-ba20-5d87e6f24790
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 135960 ms
Total Talk Time (AGENT): 76050 ms
Total Talk Time (CUSTOMER): 42783 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/65b175c0-98bf-4947-ba20-5d87e6f24790_20250113T19:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. This is [PII] calling from Baptist Hospital. I would like to check eligibility and benefits for a member, please.
[AGENT][NEUTRAL] Yeah, I could take eligibility and benefits for you. You said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do have 01611724, M as in Mary, L as in Larry, and number 8.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. Thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy. So it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] Uh, does this patient has any outpatient uh accumulation or calendar year?
[AGENT][NEUTRAL] Uh, for is this for uh outpatient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me double check that.
[AGENT][NEUTRAL] Of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is $1500 max per calendar year. I know the year just started, but let me check to see if any of that has been used. Give me just a moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so none has been used so far this year.
[CUSTOMER][POSITIVE] Thank you so much. Do you have any reference number for this call?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] A R A. Last initial is A. And was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] That's it. Thank you. Have a wonderful day.
[AGENT][POSITIVE] Alright, yeah, thanks for calling ATL you too bye bye.