AccountId: 011433970860
ContactId: 902321c0-2051-446a-a341-ecac868a8c90
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254160 ms
Total Talk Time (AGENT): 137760 ms
Total Talk Time (CUSTOMER): 63128 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/902321c0-2051-446a-a341-ecac868a8c90_20250211T19:24_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. My name is [PII]. I'm calling from Baptist Hospital. I just wanted to check if this patient was still active with APL.
[AGENT][NEUTRAL] OK, and you said that your name is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], and you're wanting to verify just if, if the policy is active or not, is that correct?
[CUSTOMER][NEUTRAL] Yes, the eligibility and then like I guess how much they've used or how much they're allotted per day.
[AGENT][NEUTRAL] So you do need benefit information as well?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][POSITIVE] Yes, I can help you with both. And [PII], how do you spell your first name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] Mhm. OK. Thank you. And your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you, [PII]. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] It is 002175427 M as in Mary, L as in Larry and then 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] OK, [PII], any information that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth, um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do say she is the spouse of the subscriber on the supplemental policy, [PII], and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And you said that you were needing inpatient, outpatient or office benefits for this number?
[CUSTOMER][NEUTRAL] Um, outpatient please.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so on this supplemental policy, she has an outpatient benefit max of $500 per covered person per calendar day for covered outpatient services with no outpatient deductible per covered person per calendar day. So this is a per day per calendar day, not a per year.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Mhm. And now, when, and when.
[CUSTOMER][POSITIVE] Alrighty, um, may I just have, I'm sorry.
[AGENT][NEUTRAL] Well, I'm, I was gonna give you a couple more pieces of information, [PII] first. So, because of it being a supplement to her primary insurance, when you all file a claim with us, we will need to also receive a copy of her primary insurance company's explanation of benefits for review.
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal that you should be able to check our claim status and and have access to our EOB by going to secured. [PII].
[CUSTOMER][POSITIVE] OK, got it, thank you.
[AGENT][POSITIVE] You are very welcome. And is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] Um, just the first initial of your last name, please.
[AGENT][NEUTRAL] [PII] and my name along with today's date will be your call reference number.
[CUSTOMER][POSITIVE] Got it. Well, thank you so much for your help, [PII]. I hope you have a great day.
[AGENT][POSITIVE] Yeah. Oh, I hope you do too, and thank you again, [PII], for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Uh-huh, bye bye.