AccountId: 011433970860
ContactId: a8061fd5-3e44-4eb6-ac01-97622e6d8eed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172369 ms
Total Talk Time (AGENT): 70507 ms
Total Talk Time (CUSTOMER): 74919 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/a8061fd5-3e44-4eb6-ac01-97622e6d8eed_20250219T20:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Baptist Hospital of Miami. I wanted to check coverage for a member.
[AGENT][NEUTRAL] I'm sure [PII] can assist you with benefits. Um, first, I'll need a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, I don't know if this is the correct policy number because um patient was having a hard time trying to verify, but I'll give you what I have. I have 21254.
[AGENT][NEUTRAL] OK. No, ma'am. That's not the correct policy number. Do you have the social?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, I do. One second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I knew it was wrong with that usually I'm more familiar U APL numbers uh have like letters and stuff, but um, yeah, so social for her is [PII].
[AGENT][NEUTRAL] OK, and please verify her name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, I have a policy number here.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] That number is 02569518.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And the effective date on this policy was [PII]. The policy is still active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient benefits.
[AGENT][NEUTRAL] For outpatient, we cover up to 8500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, has she met any or used any of that amount?
[AGENT][NEUTRAL] Um, not so far this year.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Alright, well she's gonna be happy about that because her insurance, you know, uh, her responsibility for tomorrow's appointment was like over 5000 so.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] Uh, OK, great, yeah, for an outpatient service, um, so what is your name again?
[AGENT][NEUTRAL] Um, it's [PII]. It's spelled [PII] and my last initial is [PII]. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, thank you so much. um, that's all I need. I appreciate it thank you.
[AGENT][POSITIVE] Mhm. Thank you, [PII], for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] You too thank you bye.