AccountId: 011433970860
ContactId: 719a74ce-9522-4ec7-a553-e68f074138d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372059 ms
Total Talk Time (AGENT): 179454 ms
Total Talk Time (CUSTOMER): 162125 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/719a74ce-9522-4ec7-a553-e68f074138d2_20250508T20:01_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. I'm [PII] from Baptist Hospital. I'm calling in regards to a mutual patient check eligibility and benefits.
[AGENT][NEGATIVE] OK, I am so sorry, but there is a terrible echo on our call.
[CUSTOMER][NEUTRAL] Hello, hello, hello, hello, hello. Can you hear me?
[AGENT][NEUTRAL] Uh, yes, ma'am, but you sound very far away from the phone and it's causing an echo.
[CUSTOMER][POSITIVE] Oh my goodness.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Hello now? Can you hear me now?
[AGENT][NEUTRAL] I, I, I can hear you, but it's, it's an echo on our call. I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Hey, [PII], thank you. And what is your callback number?
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] That's much better. I can hear you much better now.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] Um, and how can I help you today?
[CUSTOMER][NEUTRAL] I'm calling for eligibility and benefits.
[AGENT][NEUTRAL] OK, you're needing eligibility and benefits for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am. I can help you with both. And what is your um patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] 02597474 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is your, uh, first off, any information provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Last name would be [PII], first name is, oh, actually they have it.
[CUSTOMER][NEUTRAL] Backwards, that's weird. Um, last thing would be lower.
[CUSTOMER][NEUTRAL] [PII] and then first name would be [PII]. Date of birth would be [PII].
[AGENT][NEUTRAL] OK, so the first name is [PII], last name is [PII].
[CUSTOMER][NEGATIVE] Yes, I, they had it backwards. I don't know why. Let me fix that.
[AGENT][NEUTRAL] No, the last name, yeah, the last name is [PII].
[CUSTOMER][NEUTRAL] Yeah, I got.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so just a moment.
[CUSTOMER][NEUTRAL] The last name is [PII] and then the first name is [PII].
[AGENT][NEUTRAL] Oh.
[AGENT][NEGATIVE] No. No, no, no, no. That's wrong.
[AGENT][NEUTRAL] You had it right the first time. The last name is [PII]
[AGENT][NEUTRAL] First name is [PII]
[CUSTOMER][NEUTRAL] I, well, that's.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. Do you have the ID card?
[CUSTOMER][NEUTRAL] Uh, uh.
[CUSTOMER][NEUTRAL] Um, no, I just have to, um.
[CUSTOMER][NEUTRAL] The ID the member ID.
[AGENT][NEUTRAL] OK, so no, the last name is [PII]
[CUSTOMER][NEUTRAL] Right, it's, it's on here, the lower, lower, and then the first name is yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's the first name.
[AGENT][NEUTRAL] Lower is the first name.
[AGENT][NEUTRAL] [PII] OK. OK. Well, you said you were changing it, so I just wanted to make sure you did not change the.
[CUSTOMER][NEUTRAL] Yes, ma'am. I have it here.
[CUSTOMER][NEUTRAL] Yes, I have, yeah.
[CUSTOMER][NEUTRAL] No, no, no, it's, it's the the system is backwards, so like we have last name first and then first name like that, so that's why I was like, oh, let me change it, but if not like, it's still there, no worries.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, yeah.
[AGENT][NEUTRAL] All right. So just one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I do show that she is the spouse of the subscriber on the supplemental policy. It is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information did you need for her, [PII]? inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] So outpatient and this is a gap plan so I just need to know if how much so out of the 4000 how much has she used for [PII].
[AGENT][NEUTRAL] OK, so yes, that is the $4000 is the outpatient benefit max for this calendar for the calendar year rather, with no deductible and one moment and I can provide you.
[AGENT][NEUTRAL] The other information.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And as of now, she has used all of the benefits. It has been maxed.
[CUSTOMER][POSITIVE] She's used all of them. She has been awesome.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK. Can I get a reference number?
[AGENT][NEUTRAL] Yes, ma'am. You would use my name along with today's date.
[AGENT][NEUTRAL] And then [PII], I believe you already.
[CUSTOMER][NEUTRAL] OK. Can I get the
[AGENT][NEUTRAL] Um, what do you, what do you need?
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] What was your question?
[CUSTOMER][NEUTRAL] I was gonna say, can I get the first initial of your um last name just for verification purposes.
[AGENT][NEUTRAL] Yes and also yours. What is yours?
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then I believe you already have this, but in the future if you all have a claim that you need to check status on with APL, you can go to our portal and you should be able to check that by going to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, so the, we don't unfortunately we don't get any sys uh like access to that. We have to wait for boxes to come to us, so for now we have to call.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And that's fine. That's fine, but we always, we just want to make sure that all of our contacts are aware of the portal.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I got you, no problem.
[AGENT][NEUTRAL] So is there anything else [PII] I can help you with today?
[CUSTOMER][POSITIVE] No, ma'am. It's been answered. Thank you.
[AGENT][POSITIVE] OK. Well, you're welcome and thank you for calling [PII]. I hope you have a wonderful rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.