AccountId: 011433970860
ContactId: 7141275e-8fb9-4932-a7ec-d6f6c0228cbd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226179 ms
Total Talk Time (AGENT): 110306 ms
Total Talk Time (CUSTOMER): 49289 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/7141275e-8fb9-4932-a7ec-d6f6c0228cbd_20250521T17:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Baptist Hospital Miami. I need to get eligibility and benefit on a patient.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits, Ms. [PII]. May I please get your call back number, ma'am, just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Sure. It is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, this is for [PII]. Let me get his birthday. Give me one second.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] His birthday is [PII].
[AGENT][NEUTRAL] Thank you. And then may I have [PII]'s policy number, please?
[CUSTOMER][NEUTRAL] 01982155 M as in Mary, L as in Larry, number 8.
[AGENT][NEUTRAL] OK, thank you. Let me look that up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I do show that um let's see, 19, I look at the date of birth, [PII]. I do show that [PII] does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is to verify his benefits. It's not a guarantee of payment.
[AGENT][NEUTRAL] He has a supplemental insurance policy that's billed secondary to the primary. It helps with deductible, co-pay, and co-insurance. He has an inpatient calendar year benefit amount of $4000 and then he also has an outpatient per calendar day benefit of $500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And has to use any of the $4000?
[AGENT][NEUTRAL] Let me check for you real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Nothing has been used for the year of [PII].
[CUSTOMER][NEUTRAL] OK. Pre-certification, is it required?
[AGENT][NEUTRAL] No, ma'am. This is not the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and where should we send a claim?
[AGENT][NEUTRAL] Uh, you can send out.
[AGENT][NEUTRAL] Uh, electronically with our payer ID number, let me give that to you. It's 60801.
[AGENT][NEUTRAL] We also have a mailing address I can give that to you too.
[AGENT][NEUTRAL] And that will be.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That is in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and can I have the first initial of your last name?
[AGENT][NEUTRAL] Yes, ma'am. That is A.
[CUSTOMER][POSITIVE] OK, thank you so much for your help to have a good day.
[AGENT][POSITIVE] You have a wonderful day too, Ms. [PII]. Thank you for calling APL bye bye.
[CUSTOMER][NEUTRAL] Bye bye.