AccountId: 011433970860
ContactId: 83f274ae-9363-4a12-a4bf-223ba0ab43b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225440 ms
Total Talk Time (AGENT): 112515 ms
Total Talk Time (CUSTOMER): 41322 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=3.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/83f274ae-9363-4a12-a4bf-223ba0ab43b3_20250306T21:54_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. This is [PII] calling from Baptist Outpatient Services. I'm calling to um verify outpatient benefits for one member.
[AGENT][NEUTRAL] OK. Did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] Oh, so I'm sorry, thank you. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, and you're needing eligibility and outpatient benefits for a member, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] Yes ma'am, I can help you with that, right, and what is the member's policy number please?
[CUSTOMER][NEUTRAL] 2414221.
[AGENT][POSITIVE] OK, thank you one moment please.
[AGENT][NEUTRAL] I'm sorry, any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII], um, [PII].
[AGENT][NEUTRAL] OK, thank you. So yes ma'am, I do show she is the subscriber on the supplemental policy, and this supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And one moment on the benefits.
[AGENT][NEUTRAL] OK, and on this policy, the outpatient benefit maximum per calendar year for covered outpatient services is $1250.
[AGENT][NEUTRAL] And the outpatient deductible, there is no outpatient deductible per calendar year.
[CUSTOMER][NEUTRAL] Oh OK. Is there any accumulations?
[AGENT][POSITIVE] I can check that for you.
[AGENT][NEUTRAL] Uh no, ma'am, as of now there are not.
[CUSTOMER][POSITIVE] OK perfect thank you so much appreciate it.
[AGENT][NEUTRAL] Mm. You're welcome. Yes, ma'am, and just a couple of additional things so right, if you all will be filing a claim with us, um, on this policy, we will also need a copy of her primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status and the website for our portal is [PII].
[CUSTOMER][POSITIVE] Oh OK I got it thank you.
[AGENT][POSITIVE] Well, you're very welcome. So is there anything else that I can help you with this afternoon, [PII]?
[CUSTOMER][POSITIVE] That would be all. Have a good afternoon.
[AGENT][POSITIVE] OK, well, yes ma'am you too and thank you again for calling APL.
[CUSTOMER][POSITIVE] Mm thank you.
[AGENT][POSITIVE] You're welcome. Bye bye.