AccountId: 011433970860
ContactId: 96705f94-5a3c-4105-be71-f7827dfb55bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256559 ms
Total Talk Time (AGENT): 127369 ms
Total Talk Time (CUSTOMER): 64333 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/96705f94-5a3c-4105-be71-f7827dfb55bd_20250304T19:01_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] Good afternoon [PII]. My name is [PII] calling from Baptist Hospital to check benefits on one of your members please.
[AGENT][NEUTRAL] OK, [PII], and does your name start with a [PII]? Is that correct?
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] The other [PII]
[AGENT][NEUTRAL] OK. Thank you, [PII]. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, thank you. And [PII], did you say that you're needing eligibility and benefits?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, ma'am. I can help you with both things. And what is the member's policy number?
[CUSTOMER][NEUTRAL] I have 01679286.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And then 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] Her name is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do see that she is the spouse of the subscriber on this supplemental policy, and this supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what type of benefit information do you need for her today? [PII] inpatient, outpatient or office?
[CUSTOMER][POSITIVE] It was impatient.
[AGENT][NEUTRAL] Inpatient? OK.
[AGENT][NEUTRAL] OK, so I do see that the inpatient benefit maximum per calendar year per covered person is $2500 and there is no inpatient deductible.
[AGENT][NEUTRAL] Because this is a supplemental policy they'll to their primary insurance when the claim is submitted to us for review, we will also have to have a copy of her primary insurance company's explanation of benefits sent along with the claim.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[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 [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And [PII], uh, this 2500 covers for what?
[AGENT][NEUTRAL] That is for an inpatient admission.
[CUSTOMER][NEUTRAL] Inpatient admission for her uh coinsurance copays.
[AGENT][NEUTRAL] Yes, this policy is designed to help with co-pays, deductibles, co-insurance amounts of coverage services.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] OK perfect and can I have.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The first letter of your last name and a reference number for this call if there's one.
[AGENT][NEUTRAL] My name and today's date will be your call reference number and the first initial and my last name is [PII]. And what is yours, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And is there anything else I could?
[CUSTOMER][POSITIVE] Perfect thank you so much for all the information.
[AGENT][POSITIVE] Oh, you're welcome. OK. OK, [PII]. Well, if that's all I can help you with, thank you again for calling and I hope you, uh, calling APL and I hope you have a great afternoon.
[CUSTOMER][NEUTRAL] No, that will be all.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Same to you thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you too. Bye bye.
[CUSTOMER][NEUTRAL] Right.