AccountId: 011433970860
ContactId: 70435168-a1cc-41bf-b472-9e526f5a5901
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270640 ms
Total Talk Time (AGENT): 103343 ms
Total Talk Time (CUSTOMER): 111995 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/70435168-a1cc-41bf-b472-9e526f5a5901_20250619T18:15_UTC.wav
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[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling from Baptist Outpatient Center.
[AGENT][NEUTRAL] How may I assist you?
[CUSTOMER][NEUTRAL] Uh, do you mind spelling your name for me, please?
[AGENT][NEUTRAL] It is spelled [PII] last initial of [PII] and today's date will be used as the call reference.
[CUSTOMER][POSITIVE] Thank you, I appreciate your, your response. Uh my name is [PII] and I'm calling on behalf of a mutual patient. She's having some uh examination here at Baptist and I have a policy number. If you can please check her benefits for us.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, may I please have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the policy number.
[CUSTOMER][NEUTRAL] 02241482
[CUSTOMER][NEUTRAL] M like Mary, L like Larry, and the number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's under [PII] [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy you're calling in for benefits. Is this for inpatient, outpatient, or an office setting?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's um an outpatient free standing facility, it's a diagnostic center I don't know how you all would.
[CUSTOMER][NEUTRAL] Would have that.
[AGENT][NEUTRAL] OK, I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And for this, you're welcome and for this policy verification of coverage does not guarantee the payment of the claim. For outpatient, the member does have up to $200 per calendar day.
[CUSTOMER][NEUTRAL] I understand.
[AGENT][NEUTRAL] That will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It does not cover any preventative or wellness. Is there anything else that I can assist you with today, Navy?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So if I was to give you a CBT code, what she's having done is a CT of her pelvis.
[AGENT][NEUTRAL] OK. The only thing that I can
[CUSTOMER][NEUTRAL] So it's, it's uh an outpatient setting.
[AGENT][NEUTRAL] Yes, the only thing that I can inform you in regards to their benefits is the benefit amount. And just to let you know, we do not cover preventative or wellness. So if the procedure is due to sickness or injury, then that member does have up to $200 per calendar day.
[CUSTOMER][NEUTRAL] So that would be uh like a supplemental policy if she's hospitalized right?
[AGENT][NEUTRAL] This is a supplemental to their primary.
[CUSTOMER][NEUTRAL] OK, so they don't have any outpatient benefits?
[AGENT][POSITIVE] Yes, I gave the outpatient benefits of the $200 per calendar day that we will pay.
[CUSTOMER][NEUTRAL] OK, so 200 per day.
[CUSTOMER][NEUTRAL] Toward.
[AGENT][NEUTRAL] The primary insurance deductible coinsurance or co-pay, yes.
[CUSTOMER][NEUTRAL] Co-insurance or copay.
[CUSTOMER][NEUTRAL] OK, in this case if it's just an examination, it would be because it's not like she's um impatient, she won't be staying in the hospital, so that would be just a 200 that she would have for that day.
[AGENT][NEUTRAL] The amount for the outpatient is up to the $200 per calendar day.
[CUSTOMER][NEUTRAL] OK, for outpatient facility.
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] What is her, does she have like an annual max and a remaining amount?
[AGENT][NEUTRAL] No annual max. It's just a calendar day benefit max.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] That'll be all. Have a good one.
[AGENT][POSITIVE] You, thank you and thank you so much for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] Bye bye.