AccountId: 011433970860
ContactId: 7664a3d4-1888-4a8d-959f-e03ec356f88b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282600 ms
Total Talk Time (AGENT): 139128 ms
Total Talk Time (CUSTOMER): 64492 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/7664a3d4-1888-4a8d-959f-e03ec356f88b_20250210T21:35_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII]. I'm calling from Baptist Outpatient Services, uh, just to verify the benefits for a patient.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, [PII], you're needing, do you also need eligibility or only benefits for outpatient?
[CUSTOMER][NEUTRAL] Uh, both actually.
[AGENT][POSITIVE] OK, yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] would be [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] That's gonna be 02271370 MLA.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, is this going to be for a future data service or a past data service that you're needing eligibility on?
[CUSTOMER][NEUTRAL] It will be for a future data services.
[AGENT][NEUTRAL] OK. So let me give you a different policy number. That policy number is an old policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The termed that policy number you gave me termed 101 of 2023. The current active policy is 2556504.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you today, [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] Her name is [PII] and the last name is [PII], [PII]
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so I do show she is the spouse of the subscriber on the supplemental policy, [PII], and again the effective date on it is [PII].
[AGENT][NEUTRAL] And just to re verify, you did say you were needing outpatient benefits for this number, is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this supplemental policy there is she has an $8700 outpatient calendar year max benefit for covered outpatient services with no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK. Is there any accumulations to that?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And no, ma'am, there is not, not as of now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when the claim is submitted to APL for review, [PII], we must also get a copy of her primary insurance company's explanation of benefits for review as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Along with the claim.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal that you should be able to check claim status for us and have access to our EOBs and the portal website for us is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you for that.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And is there anything else that I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, [PII], that would be all for today. Thank you. May I just get a last name initial to your name and a reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] My name in today's date will be your call reference number and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right, thank you so much, [PII] have a great afternoon.
[AGENT][POSITIVE] You, I hope you do too, and thank you again for calling APL today, [PII], if that's all I can help you with.
[CUSTOMER][POSITIVE] Yes ma'am thank you have a great day.
[AGENT][POSITIVE] You're welcome. You too. Bye-bye.
[CUSTOMER][NEUTRAL] OK