AccountId: 011433970860
ContactId: c92f4471-d3f1-4a44-b44d-6fad8c067595
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241080 ms
Total Talk Time (AGENT): 104594 ms
Total Talk Time (CUSTOMER): 48374 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/c92f4471-d3f1-4a44-b44d-6fad8c067595_20250130T15:04_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 Outpatient Services. I'm calling to verify the member's active and what her outpatient benefits are.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], so you're needing eligibility and benefit information for members, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Uh, a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Uh, it says 01845808 ML 8.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] So I do show she is a subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And one moment for her benefit information and you said outpatient, correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so on the supplemental policy, the outpatient benefit maximum.
[AGENT][NEUTRAL] Per calendar year for covered outpatient services per person is $1000 with no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, it's 1000 remaining.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] As of now, she has not used any of her benefits for this calendar year.
[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] And when the claim is
[CUSTOMER][NEUTRAL] OK, is there a reference number to the call?
[AGENT][NEUTRAL] Yes, ma'am, and just a couple of additional things [PII], when the claim is submitted to APL for review, we must also have a copy of her primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] And then once we have processed our claim we do have our portal that you can check claim status in and that website for the portal is secured.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, can I help you with anything else?
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] OK, well thank you again for calling APO and I hope you have a great day.
[CUSTOMER][NEUTRAL] Oh, what's the the.
[CUSTOMER][NEUTRAL] That's uh what is it called? the reference number for the call.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] Oh, what's the first letter of your last name?
[AGENT][NEUTRAL] Yes and yours?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you very much.
[CUSTOMER][POSITIVE] All right, thank you so much. Have a good day, bye.
[AGENT][NEUTRAL] All right, well have you too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.