AccountId: 011433970860
ContactId: bf583588-d2e3-4e9c-ba73-0da5ac6fdca6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 187330 ms
Total Talk Time (AGENT): 64211 ms
Total Talk Time (CUSTOMER): 70854 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/bf583588-d2e3-4e9c-ba73-0da5ac6fdca6_20250527T20:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, my name is [PII]. I'm calling from Baptist Health Hospital, and, um, I want to confirm the eligibility of a mutual patient.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. And policy number for that patient?
[CUSTOMER][NEUTRAL] 01341920.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII]. Date of birth [PII].
[AGENT][NEUTRAL] I show this policy is active and effective [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, any deductible or out of pocket?
[AGENT][NEUTRAL] And that was for outpatient services.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And by the way, yes, for outpatient.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] That's not a guarantee of payment basic outline of the policy.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, they have 3500 calendar year maximum benefit payable after primary has processed the claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there's no deductible.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] OK, great. um, has the patient met any out of pocket so far?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, she's only used $70 of the $3500 available.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] OK, I do also have to confirm um.
[CUSTOMER][NEUTRAL] For chemotherapy, um, and injections, what, what is the coverage?
[AGENT][NEUTRAL] Is it an outpatient hospital setting?
[CUSTOMER][NEUTRAL] Yes, um, everything I'm going to ask is outpatient.
[AGENT][NEUTRAL] Yeah, so this, this would be for any services rendered in an outpatient hospital setting.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's the same coverage.
[AGENT][NEUTRAL] The 3500.
[CUSTOMER][NEUTRAL] And what is the
[AGENT][NEUTRAL] For any out
[CUSTOMER][NEUTRAL] Oh OK so she has to meet.
[AGENT][NEUTRAL] No, there's there's nothing to meet. So this is a secondary gap policy. Once primary processes the claims, anything that's left over, we will pay up to 3500 in a calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, the max. I'm so sorry. I, OK, thank you very much. Is there um an uh um.
[CUSTOMER][NEUTRAL] A reference number to this call?
[AGENT][NEUTRAL] Uh, reference number is just my name, [PII]. First initial to last name is D as [PII], and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] OK, thank you very much for your time you have a wonderful afternoon.
[AGENT][POSITIVE] Thank you for calling APL. You as well. Bye bye.