AccountId: 011433970860
ContactId: 73885257-6f20-4291-8078-f25f69c2317e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273940 ms
Total Talk Time (AGENT): 128585 ms
Total Talk Time (CUSTOMER): 63399 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/73885257-6f20-4291-8078-f25f69c2317e_20250409T18:59_UTC.wav
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[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Baptist Outpatient services.
[CUSTOMER][NEUTRAL] On behalf of a patient, um, to get the benefits please.
[AGENT][NEUTRAL] OK, [PII], you're only needing benefits. You do not need.
[AGENT][NEUTRAL] Eligibility, is that correct?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, eligibility as well.
[AGENT][POSITIVE] Yes, I can help you with both and what is that number for you please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I'm sorry, you cut off.
[AGENT][NEUTRAL] What is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] 0197.
[CUSTOMER][NEUTRAL] 3186.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry.
[CUSTOMER][NEUTRAL] And the number 8
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information that I do provide for you, [PII] will 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], date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and
[AGENT][NEUTRAL] I do show that she is a subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] For outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so she has an outpatient benefit maximum.
[AGENT][NEUTRAL] For covered outpatient services per calendar day in the amount of $500.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, you cut off at the end. So you said she has uh abimum.
[AGENT][NEUTRAL] Because this a supplemental.
[AGENT][NEUTRAL] Her outpatient benefit maximum, her
[CUSTOMER][NEUTRAL] Maximum amount per capita day of 500.
[AGENT][NEUTRAL] Uh-huh, for covered outpatient services.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Because this is a supplemental policy to her primary insurance, when the claim is submitted to us for review, we will also need a copy of her primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] As well, and then once we have processed the claim here at APO Melissa, we do have a portal that you should be able to check claim status in by going to secured.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Calm
[CUSTOMER][NEUTRAL] Alrighty, can I please have your name?
[AGENT][POSITIVE] All [PII].
[AGENT][NEUTRAL] Again, my name is [PII] and my name in today's date will be your call reference number.
[CUSTOMER][NEUTRAL] [PII], correct?
[AGENT][NEUTRAL] And is there anything else?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] OK, no, that'll be.
[CUSTOMER][POSITIVE] That'll be it. I appreciate your time.
[AGENT][POSITIVE] Well, you're very welcome and thank you again for calling APY. I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] Thank you.