AccountId: 011433970860
ContactId: e8cd633f-88a1-42a7-8195-32e7b9046cc0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316940 ms
Total Talk Time (AGENT): 110505 ms
Total Talk Time (CUSTOMER): 65767 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/e8cd633f-88a1-42a7-8195-32e7b9046cc0_20250515T20:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I, I need to know if a patient is active with you guys.
[AGENT][NEUTRAL] Sure, I can check eligibility for you. Can I get your name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] I'm sorry, can you repeat that? My, my phone cut out for a second.
[CUSTOMER][NEUTRAL] It's OK. My name is [PII]. That's [PII]
[AGENT][NEUTRAL] OK, and are you calling from a provider's office?
[CUSTOMER][NEUTRAL] Yes, I'm, well, I'm calling from a hospital, Baptist Hospital in [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh, sorry.
[AGENT][POSITIVE] OK, thank you so much. And the policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] The policy number is 02616798.
[AGENT][NEUTRAL] OK, one moment while I check on that for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Hi, I'm sorry, what was that?
[AGENT][NEUTRAL] Can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying that for me.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] It looks like this policy is active with an effective date.
[AGENT][NEUTRAL] Of [PII], this is a medlink policy, which means it is a secondary gap policy and what that means is primary, the primary major medical insurance will need to pay first and this can pick up the deductible, co-pay or co-insurance, but if the major medical denies the claim, then this policy will also deny that claim.
[CUSTOMER][NEUTRAL] OK, got it. So, up to how much um is the patient allowed per year for hospital outpatient?
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][NEUTRAL] So they have an inpatient benefit of up to $1000 per calendar year and an outpatient benefit maximum of up to $1000 per year. Now this is a verification of benefits and not necessarily a guarantee of payment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, got it. And has the patient used anything towards $1000 for the year, do you know?
[AGENT][POSITIVE] I can check on that for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEGATIVE] It looks like nothing has been used yet.
[CUSTOMER][POSITIVE] OK, perfect. And what was your name again?
[AGENT][NEUTRAL] To date.
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And as a call reference number, you can use my name, my first name and my last initial which is [PII], and today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII]. I hope you have a great day.
[AGENT][POSITIVE] OK, thank you for calling APL and have a great day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.