AccountId: 011433970860
ContactId: 9b2e06e5-df5c-46f4-9e60-06f3ac16e6d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192149 ms
Total Talk Time (AGENT): 107530 ms
Total Talk Time (CUSTOMER): 39718 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/9b2e06e5-df5c-46f4-9e60-06f3ac16e6d1_20250221T16:10_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] 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 Outpatient Services. I'm calling to see the outpatient benefits for a member.
[AGENT][NEUTRAL] OK, [PII], are you only needing benefit information or do you also need eligibility as well?
[CUSTOMER][NEUTRAL] No, just benefit information, please.
[AGENT][POSITIVE] Yes, I can help you with that. And you [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you. And your the member's policy number, please?
[CUSTOMER][NEUTRAL] Yes, the member's policy number is 02141248.
[AGENT][POSITIVE] OK, thank you one moment please.
[AGENT][NEUTRAL] And you list is any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so he is the spouse of the subscriber on this supplemental policy. And what type of benefit information are you needing for him, inpatient, outpatient, or office?
[CUSTOMER][NEUTRAL] Outpatient employees.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the outpatient benefit maximum per calendar day for covered outpatient services is $500 per covered person and there is no outpatient deductible per covered person per calendar day.
[AGENT][NEUTRAL] Because this is a
[CUSTOMER][NEUTRAL] OK and you said that's 500. I'm sorry.
[AGENT][NEUTRAL] Correct, per calendar day for covered outpatient services.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the, because this is a supplemental policy to the primary insurance leases once the claim or when you submit the claim rather to APL, we will also have to have a copy of the primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim we do have a portal in which you should be able to check claim status and have access to our EOB by going to [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, thank you for all your help today, [PII]. Could I have the initial your last name please and a reference number for this call?
[AGENT][NEUTRAL] You are
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes, the first initial to my last name is [PII], and my name along with today's date will be your call reference number.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you. And if that's again, all I can help you with, I hope you have a wonderful weekend and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you as well.