AccountId: 011433970860
ContactId: 6976c8b1-93cc-44ca-a9b1-148ec90ee778
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241020 ms
Total Talk Time (AGENT): 120078 ms
Total Talk Time (CUSTOMER): 52568 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/6976c8b1-93cc-44ca-a9b1-148ec90ee778_20250416T20:21_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from Baptist Hospital of Miami. I needed to verify a patients, um, allowed amount per year please.
[AGENT][NEUTRAL] OK, you're needing to get benefit information for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My first name is [PII]. Last name [PII].
[AGENT][NEUTRAL] You said your first name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] It is 02337082 M as in Mary L 8.
[AGENT][NEUTRAL] Thank you. One moment please while I get the information pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you would 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] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on the supplemental policy and it is active, [PII], with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for him, inpatient, outpatient, or office?
[CUSTOMER][NEUTRAL] Outpatient hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and on this supplemental policy, the outpatient benefit maximum per calendar year for covered person for covered outpatient services is $1000.
[AGENT][NEUTRAL] And there is no outpatient deductible per cover person per calendar year.
[AGENT][NEUTRAL] Because this is a supplemental policy. Go ahead.
[CUSTOMER][NEUTRAL] OK. Has that been, mhm.
[AGENT][NEGATIVE] There have not been any benefits used for him as of now for this calendar year.
[CUSTOMER][NEGATIVE] Nothing has been met or used towards the 1000.
[AGENT][NEUTRAL] Towards his benefit, Max? No, ma'am, not as of right now. There has not been.
[CUSTOMER][POSITIVE] OK, perfect. Can I get your name please?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] You will use my name in today's date as your call reference number and if you all will be filing a claim for this policy, we will also have to have a copy of the primary insurance company's explanation of benefits for review.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And then once we've processed our claim [PII], we do have a portal that you should be able to check claim status in by going to secured.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK perfect thank you I appreciate your help.
[AGENT][POSITIVE] Well, you're welcome. So is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] OK. Well then, thank you so much for calling APL and I hope you have a nice uh rest of your day.
[CUSTOMER][POSITIVE] You too. Thank you.