AccountId: 011433970860
ContactId: cf300587-3cef-49d9-a16a-16bbbd0a805f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173679 ms
Total Talk Time (AGENT): 115618 ms
Total Talk Time (CUSTOMER): 41462 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/cf300587-3cef-49d9-a16a-16bbbd0a805f_20250307T14:23_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, Ms. [PII]. My name is [PII]. I'm calling from Baptist Outpatient Services. I need to verify that a patient's plan is active and how much is remaining in their outpatient services.
[AGENT][POSITIVE] OK, [PII], I'll be glad to help you. Go ahead and give me a good policy number please, ma'am.
[CUSTOMER][NEUTRAL] Yes, 02437004.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] [PII], no extension.
[AGENT][POSITIVE] Alrighty, thank you so much for that information, [PII]. Now your patient's name and date of birth.
[CUSTOMER][NEUTRAL] The Perez's date of birth is [PII].
[AGENT][NEUTRAL] Alrighty, thank you, [PII], for all that information. Looks like Lisette is the insured on this medical supplemental plan. I do show the original effective date is [PII]. Patient is currently active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want to know if the patient is active and how much they have used for this year, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alrighty, let's see, the patient is active.
[AGENT][NEUTRAL] And let's see if they've used any benefits.
[AGENT][NEGATIVE] No, ma'am, as of today, he's not used any of his [PII] benefit. I mean, she has not used any of her benefits.
[CUSTOMER][NEUTRAL] OK, and how much is remaining?
[AGENT][NEUTRAL] Uh, let's see what her benefit is. Are you needing inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Outpatient, please.
[AGENT][NEUTRAL] Outpatient, OK, get that pulled up. Let's see now, of course what we are is just her medical supplemental plan, [PII].
[AGENT][NEUTRAL] So the only thing that we would pick up and pay on is anything for sickness and injury that is applied towards her deductible copay or co-insurance and her primary insurance carrier. If it is routine, it's not covered here at all, no matter what, but her outpatient benefit here is a zero deductible, no pre-cert, $2500 benefit payable for outpatient per calendar year.
[CUSTOMER][POSITIVE] OK, perfect. Can you please provide me the first
[AGENT][NEUTRAL] Is that all I can help you with? No. Uh-huh.
[CUSTOMER][NEUTRAL] Yes, the first initial of your last name and a reference number, please.
[AGENT][NEUTRAL] Well, we do not give reference numbers, but is that all that I can help you with today?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alrighty. My name is [PII] and you can use my name with today's date if you need to do so, [PII].
[CUSTOMER][POSITIVE] Thank you so much, Ms. [PII]. You have a great day.
[AGENT][POSITIVE] Alrighty. You as well and happy Friday and thanks for calling APM [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.