AccountId: 011433970860
ContactId: 814442b8-8de5-4f66-a8b0-4632ee8ccd76
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160699 ms
Total Talk Time (AGENT): 81172 ms
Total Talk Time (CUSTOMER): 53129 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/814442b8-8de5-4f66-a8b0-4632ee8ccd76_20241231T19:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey there, this is [PII] from Baptist Health. Um, I'm calling, um, for eligibility just to verify eligibility for this patient and also just to make sure that you guys are in network with us. Would that, would you be able to help with that?
[AGENT][NEUTRAL] I'm sure [PII], I can assist you with benefits. Um first, could I get a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] 0257617777.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, so cardiac, C A [PII] I [PII].
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. And is this for an office visit or outpatient visit or?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK. For outpatient under, under this policy, we cover up to 4 outpatient visits per calendar year.
[AGENT][NEUTRAL] And we cover up to $50 per visit, and he gets 4 visits per year, and that's he has used in it.
[AGENT][NEUTRAL] No, all 4 visits are available.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK, um, would you be able to give me an amount for a procedure?
[AGENT][NEUTRAL] Um, no, ma'am, because we don't go by the procedures, we go by the place of service.
[CUSTOMER][POSITIVE] Got you OK alright thank you.
[AGENT][POSITIVE] OK, no problem. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Um, do you have a reference number for this call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. Um my name is [PII]. It's spelled [PII] Last [PII] is [PII] and today's date. And um you also did ask about networks um to see if you guys are in network. We actually don't, we actually work with our providers. We don't go by network.
[CUSTOMER][POSITIVE] Got you, perfect, OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][POSITIVE] All right, thank you so much you have an amazing holiday, OK?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Bye bye