AccountId: 011433970860
ContactId: d080035c-2e33-4453-b348-4dcb41d92a1e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 148919 ms
Total Talk Time (AGENT): 60593 ms
Total Talk Time (CUSTOMER): 54131 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/d080035c-2e33-4453-b348-4dcb41d92a1e_20250513T15:44_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, good morning, [PII]. My name, my name is [PII], and I'm calling from Baptist Health Medical Group, and I'm calling to verify if a patient has any coverage for specialist, um, office visit.
[AGENT][NEUTRAL] OK, I can help you with benefits. Um, and I'm sorry, I missed your name. What was that?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII]. OK, thank you so much. I appreciate that. And then do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, uh [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have that policy number for that patient?
[CUSTOMER][NEUTRAL] Yes, 01611589 M as in Mary, L as in Lourdes, number 8.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you. And patient name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK. And let me get her policy pulled up. Uh, her effective date is [PII]. She's currently active. This is not a guarantee of payment, basic outline of the policy.
[AGENT][NEUTRAL] And you said uh outpatient specialist office is, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] Um, so she has a $1500 per covered person per calendar year benefit payable. Um, this is secondary, so it'll pay after primary insurance processes the claim. It does not cover the actual office visit, however, it does cover treatment and procedures performed in office.
[CUSTOMER][NEUTRAL] OK, so it's um
[CUSTOMER][NEUTRAL] Only for treatment and procedures.
[CUSTOMER][NEUTRAL] OK, and you said that it's $1000 maximum?
[AGENT][NEUTRAL] Uh, 1500, 1500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Max
[CUSTOMER][NEUTRAL] OK, um, can I have a reference number for this call?
[AGENT][NEUTRAL] Uh, reference number is my name is [PII], first initial to last name, [PII], and today's date. And anything else I can help with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, no, that's it, thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you.