AccountId: 011433970860
ContactId: 6b338cf0-d772-4907-b22c-a29eca23930a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288760 ms
Total Talk Time (AGENT): 142281 ms
Total Talk Time (CUSTOMER): 116492 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/6b338cf0-d772-4907-b22c-a29eca23930a_20250604T14:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good morning. Um, my name is [PII] and I'm calling from Baptist Health. Um, I have a patient that I need, um, her, um, benefits. If you could help me with that, it'd be greatly appreciated.
[AGENT][POSITIVE] Yeah, I can definitely check those benefits for you. I'm sorry, would you mind spelling out your name for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Absolutely. [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you that is very pretty. uh, [PII], can I get a good call back number from you, uh, in case we're disconnected please.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] I do. 0186144 ML 8.
[AGENT][NEUTRAL] OK, um, I'm sorry, uh, before the MLA that was 0186144.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so it appears that we are missing a digit there um do you maybe have their, uh, social I could search for them that way.
[CUSTOMER][NEUTRAL] Ah
[CUSTOMER][NEUTRAL] Uh, let me get that for you. Give me one second.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I don't know that I have her social but I may have I'm hoping that I have something else that could help uh here let me.
[AGENT][NEUTRAL] Sure, um, if not with the it would have to be the full social um if you don't have that, the only other way I can search is if you wouldn't mind spelling out the first and last name for me.
[CUSTOMER][NEUTRAL] Absolutely. Uh, so that I do have right on hand. Um, her first name, I'll spell it for you, is [PII].
[AGENT][NEUTRAL] OK. Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Her last name [PII], but [PII] the ending in [PII] [PII], it ends in [PII].
[AGENT][POSITIVE] Got it. OK, thank you one moment.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then did you have this member's date of birth?
[CUSTOMER][NEUTRAL] I do. [PII].
[AGENT][POSITIVE] Got it. Thank you so much for verifying that. I was able to find this policy. Um, let me know when you're ready and I'll give you that policy number.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, go for it.
[AGENT][NEUTRAL] That is 01846144.
[CUSTOMER][NEUTRAL] 6144 no letters, that's the only number you have so it's I'll I'll repeat it 01846144.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Correct, um, the ML8 or ML7, that's only for, um, the difference is like for uh inpatient would be the ML7 outpatient would be the ML 8. The digits before the M though that's the actual policy number.
[CUSTOMER][POSITIVE] OK perfect alrighty sounds good mhm.
[AGENT][NEUTRAL] Yes, alrighty. So of course, this policy is active, uh, that effective date was [PII].
[AGENT][NEUTRAL] And uh this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we're really need to look at the inpatient or outpatient benefits for this number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, that would be for outpatient. She was part of our, uh, she was in our urgent care yesterday.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, OK. Just a moment. Alright, and of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so that outpatient benefit pays on a, uh, per calendar year basis. Uh, it is $7900 max per calendar year. If you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so she has only used $50 of that benefit so far this year.
[CUSTOMER][POSITIVE] OK, so she's covered all right thank you so much.
[AGENT][POSITIVE] Absolutely. Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] Alrighty
[CUSTOMER][POSITIVE] Uh, no, just have a wonderful day. Thank you so much. You've been a great help.
[AGENT][POSITIVE] Yeah, thanks for calling HPL you too. Alright, thank you, my pleasure. Bye bye.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm