AccountId: 011433970860
ContactId: c0f59b49-5c0a-47ec-aa8a-bb569e0f2aa4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223830 ms
Total Talk Time (AGENT): 106168 ms
Total Talk Time (CUSTOMER): 61550 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/c0f59b49-5c0a-47ec-aa8a-bb569e0f2aa4_20250625T17:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how are you, [PII]? My name is [PII]. I'm giving you a call from Baptist Outpatient Services. I was calling to see if you can please help me, um, excuse me, I'm sorry, if you can please help me obtaining outpatient benefits for a mutual patient.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], you're needing to verify benefits. Do you also need eligibility or just benefit information?
[CUSTOMER][NEUTRAL] Um, just benefit information.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And what is a good callback number for you please, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] The policy number I have here is 025700.
[CUSTOMER][NEUTRAL] 55 ML 8.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments please to get the member's information pulled up.
[AGENT][NEUTRAL] And [PII], any information that I can provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And what type of benefit information do you need for him, inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on the supplemental policy, the outpatient benefit maximum per calendar year for covered outpatient services is $6000 and there is no outpatient deductible for covered person per calendar year.
[AGENT][NEUTRAL] Because this is a supplemental policy, [PII] to as primary insurance, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then once we've processed our claim here we do have our portal that you should be able to check claim status in and the website for our portal is located at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, perfect. Um, I was wondering if you can help me with the to check if they've used any of the 6000 for this year.
[AGENT][NEGATIVE] As of now, no benefits have been used for this calendar year. Again, that's as of now.
[CUSTOMER][POSITIVE] OK perfect OK perfect can I please um.
[AGENT][NEUTRAL] For the reference number, sure, it would be my name along with today's date.
[CUSTOMER][NEUTRAL] Have a reference number for the call?
[CUSTOMER][NEUTRAL] OK, and your name? I'm so sorry I I didn't catch it in the beginning.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], OK, perfect, and your last name initial [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] OK, well then if that's all I can help you with, [PII], thank you for calling APL and I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] Thank you you too take care bye bye.
[AGENT][POSITIVE] Mm, yes, ma'am. You too. Thank you. Bye-bye.