AccountId: 011433970860
ContactId: e4bd1cd7-6e92-493a-85e2-6ca3b79a6495
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174059 ms
Total Talk Time (AGENT): 84300 ms
Total Talk Time (CUSTOMER): 36950 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/e4bd1cd7-6e92-493a-85e2-6ca3b79a6495_20250425T15:05_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling from Baptist Outpatient Services. I'm calling to see benefits for a patient for outpatient benefits.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], do you also need eligibility or only benefits?
[CUSTOMER][POSITIVE] Just benefits.
[AGENT][POSITIVE] Yes, ma'am. I can help you. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number.
[CUSTOMER][NEUTRAL] Mm let's see what it says here.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Um, it says your member ID number is 2317834.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] And any information that is provided today would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth, please, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Uh, 22863.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so on this supplemental policy, the outpatient benefit maximum per calendar year for covered outpatient services is $4000.
[AGENT][NEUTRAL] And there is no outpatient deductible per calendar year.
[AGENT][NEUTRAL] Because it isn't
[CUSTOMER][NEUTRAL] And how much is remaining?
[AGENT][NEUTRAL] Mhm. I can check that and because it is a supplement to the primary insurance, we would have to have a copy of the primary insurance company's explanation of benefits. Mhm. OK.
[CUSTOMER][NEUTRAL] That you, yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you are asking about this calendar year?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] As of now, she has not used any benefits for this calendar year.
[CUSTOMER][POSITIVE] Awesome, alright, is there a reference number to the call?
[AGENT][NEUTRAL] Yes ma'am, you would use my name along with today's date and then [PII], do you also already have our portal in which claim status should be able to be checked once it's been processed by APO?
[CUSTOMER][NEUTRAL] Oh, that's uh the claims department. I just verify the insurance.
[AGENT][NEUTRAL] OK. All right. Well, is there anything else that I can help you with?
[CUSTOMER][POSITIVE] No, that's it thank you have a good day.
[AGENT][POSITIVE] OK, well I hope you have a good day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye.