AccountId: 011433970860
ContactId: 96e6405d-cf30-4302-9508-4d71004ecac3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209100 ms
Total Talk Time (AGENT): 88376 ms
Total Talk Time (CUSTOMER): 123571 ms
Interruptions: 6
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/96e6405d-cf30-4302-9508-4d71004ecac3_20250224T23:05_UTC.wav
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[CUSTOMER][NEUTRAL] Yo babe, I just used your ass commute what?
[AGENT][NEUTRAL] This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Hey, how's it going [PII]? Um, I just wanna verify some member availability.
[AGENT][NEUTRAL] Sure, I could check eligibility. Uh, what was your name?
[CUSTOMER][NEUTRAL] [PII] calling on behalf of Baptist South Miami.
[AGENT][NEUTRAL] OK, I'm sorry, that was [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Oh got you OK and then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What's the number? [PII]. Of course I do. Give me a quick second.
[AGENT][NEUTRAL] Got it thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number will be.
[CUSTOMER][NEUTRAL] Insurance policy number is 023-296-88.
[AGENT][NEUTRAL] Alright thank you and then uh what was the name and date of birth for the patient please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, so his name is [PII]. [PII], and his date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Uh, effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now that we have the
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and what's the ER ER, uh, visit? What would it be?
[AGENT][POSITIVE] Sure, give me just a moment, I'll get that benefit info.
[AGENT][NEUTRAL] And of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so the outpatient benefit is $3500 max per calendar year and if you'll give me one moment I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, yeah, he was just admitted right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so he has used a bit already um.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh yeah that's the.
[AGENT][NEUTRAL] He has used $2,784.37 so far this year.
[CUSTOMER][NEUTRAL] 3000
[CUSTOMER][NEUTRAL] $784
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So co-pay, co-insurance, like how does it go for that?
[AGENT][NEUTRAL] So as long as his major medical uh pays, then this policy can help with that.
[CUSTOMER][NEUTRAL] Uh, and this policy can help with that. Got it OK and.
[AGENT][NEUTRAL] We would just need that primary EOB when y'all file the claim.
[CUSTOMER][POSITIVE] Perfect, and can I have your, your fir your name and a reference number for this call?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] last [PII] is [PII], and was there anything else I can help you with?
[CUSTOMER][NEUTRAL] No sounds good.
[AGENT][POSITIVE] OK, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEGATIVE] No thank you you take care now.
[AGENT][POSITIVE] Thank you you too bye bye.