AccountId: 011433970860
ContactId: 922aea12-f1ec-43bc-b73e-232b1f6c5af5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215500 ms
Total Talk Time (AGENT): 94787 ms
Total Talk Time (CUSTOMER): 68717 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/922aea12-f1ec-43bc-b73e-232b1f6c5af5_20250529T13:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I am calling from a facility named Baptist Outpatient, and we were calling to verify a member's um outpatient gap insurance benefits.
[AGENT][NEUTRAL] OK, you're needing to verify, do you also need eligibility, [PII], or only the benefits?
[CUSTOMER][NEUTRAL] Both, I would need, yeah.
[AGENT][NEUTRAL] OK, I can help you with both and what is your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] It's 02611536.
[AGENT][NEUTRAL] OK, [PII]. Thank you. One moment, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And [PII], again, any information provided will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], um, is spelled [PII]. It says [PII], it's [PII]
[CUSTOMER][NEUTRAL] [PII] last name.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And again you said that you were needing outpatient benefits, is that correct?
[CUSTOMER][NEUTRAL] Yeah, cause the numbers coming in for some diagnostic um imaging.
[CUSTOMER][NEUTRAL] Exams like a mammogram and ultrasound.
[AGENT][NEUTRAL] OK, so for covered outpatient services, the outpatient benefit maximum on this policy is $6500 per calendar year with no deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And because it is a supplement.
[CUSTOMER][NEUTRAL] And I'm assuming it started.
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Right. Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] No, no, I'm sorry, I interrupted you.
[AGENT][NEGATIVE] And as of now, she has not used any of her benefits.
[CUSTOMER][NEUTRAL] OK, that was my question.
[CUSTOMER][NEUTRAL] All right, Ms. [PII], um, do you provide a reference number?
[AGENT][NEUTRAL] Yes ma'am, you will use my name along with today's date and then if you all do file a claim with us for her, [PII], once the claim has been processed here at APL, we do have our portal in which you should be able to check claim status and the website for the portal is located at [PII].
[CUSTOMER][POSITIVE] OK, thank you. That's all for today.
[AGENT][POSITIVE] OK. Well, OK, then. Well, if that's all I can help you with, thank you for calling APO and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] Likewise bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.