AccountId: 011433970860
ContactId: 98da9fb4-4a1d-4f09-83af-3de0da02f34b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242600 ms
Total Talk Time (AGENT): 99931 ms
Total Talk Time (CUSTOMER): 71218 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/98da9fb4-4a1d-4f09-83af-3de0da02f34b_20250124T15:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling from Baptist Health, and I was just giving you a call because I have a patient who's here with us now, and I need to verify his APL of secondary insurance.
[AGENT][NEUTRAL] OK, so you're needing eligibility and benefit information on a member, is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, I can help you. And what is your callback number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Thank you. And your uh the member's policy number?
[CUSTOMER][NEUTRAL] Um, the policy number is 02281888ML.
[AGENT][POSITIVE] Thank you, one moment please.
[AGENT][NEUTRAL] And any information, [PII] that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] First name is [PII] Last name is [PII] Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So I do show that he is the subscriber on this supplemental policy and the supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information are you needing? inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Alright, so on this supplemental policy, the outpatient benefit maximum is $2000 per covered person per calendar day for covered outpatient services, and there is no outpatient deductible per cover person per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because this is a supplemental policy to his primary insurance. When the claim is submitted to APL [PII], we will also have to have a copy of his primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] No I understand.
[AGENT][NEUTRAL] And then once we have processed our claim we do have a portal that you should be able to check claim status in by going to secured.
[CUSTOMER][NEUTRAL] OK. Um, well, I, I have a patient with me. The only thing I need, I'm sorry to cut you off, but I just don't have that much time. Um, I just need to know when did you say his policy was active? It started when?
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], I thought it was [PII]. OK, great. I'm super sorry, that's actually everything that I needed. Um, do you have a reference number that I can add?
[AGENT][NEUTRAL] My name and today's date, my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][POSITIVE] OK great thank you ma'am.
[AGENT][POSITIVE] You're very welcome
[AGENT][POSITIVE] And if that's all I can help you with, thank you again for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] Alright, take care.
[CUSTOMER][NEUTRAL] Yes.