AccountId: 011433970860
ContactId: 9065d19c-9ae0-4114-81c0-8a3c8cb96d2b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188479 ms
Total Talk Time (AGENT): 108352 ms
Total Talk Time (CUSTOMER): 66700 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/9065d19c-9ae0-4114-81c0-8a3c8cb96d2b_20250320T14:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, yes, good morning. I'm calling from Baptist Health. My name is [PII]. I'm calling in regard in regards to a mutual patient that we have. I'm just calling to see, um, check the eligibility of this patient, please.
[AGENT][POSITIVE] Alright, I got, I'll be glad to help you. Go ahead and give me your policy number, please.
[CUSTOMER][NEUTRAL] Policy number will be 02597474 M as in Mary, L as in Lilo number 8.
[AGENT][POSITIVE] Alrighty, thank you so much for that information, uh, [PII]. And what is your patient's name and date of birth today?
[CUSTOMER][NEUTRAL] OK, so date of birth is [PII].
[CUSTOMER][NEUTRAL] And the day is [PII].
[AGENT][POSITIVE] Alrighty, and go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] Yes, the phone number is, allow me one second.
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alrighty, and [PII], thank you for that information. That looks like [PII] is the dependent spouse on this medical supplemental plan. I do show his original effective date is [PII]. Patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want some type of benefit. Is that correct?
[CUSTOMER][NEUTRAL] Yes. For, this is gonna be for urgent care.
[AGENT][NEUTRAL] OK, but go ahead.
[AGENT][NEUTRAL] Urgent care, so outpatient. Alright, let me get over that benefit. Uh, let's see. Now of course what we are is her medical supplemental plan. So the only thing that we would pick up on is anything for sickness and injury that is applied towards her deductible, co-pay or co-insurance and her primary insurance carrier.
[AGENT][NEUTRAL] And her outpatient benefit here, which is what urgent care is considered as a zero deductible, no pre-cert, and a $4000 per calendar year benefit.
[CUSTOMER][NEUTRAL] OK, so 0 deductible?
[AGENT][POSITIVE] Mhm, correct.
[CUSTOMER][NEUTRAL] Let's see. You have coinsurance?
[CUSTOMER][NEUTRAL] $4000 per calendar year.
[AGENT][NEUTRAL] No ma'am, where are the medical supplemental plans. The only thing that we will pick up and pay on is if her primary applies it towards her co-pay deductible or co-insurance.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Perfect. OK, let me just add it here.
[AGENT][NEUTRAL] Yes, ma'am. That would be what we would pick up and pay them. Mhm.
[CUSTOMER][NEUTRAL] OK, and if I can have uh your name, please?
[AGENT][NEUTRAL] Yes, ma'am. My name is [PII] and that is spelled [PII] And is that all that I can help you with today, [PII]?
[CUSTOMER][POSITIVE] That'd be all, thank you so much for your help.
[AGENT][POSITIVE] Alright, that's good. Thank you for calling APO and you have a great rest of your day.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] All right.