AccountId: 011433970860
ContactId: eded2852-3c00-4ab0-b816-877d146c5aa0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 151679 ms
Total Talk Time (AGENT): 70994 ms
Total Talk Time (CUSTOMER): 57290 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/eded2852-3c00-4ab0-b816-877d146c5aa0_20250512T16:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, um, this is [PII] calling from Baptist Health. I'm, I'm a provider just verifying patients eligibility and benefits.
[AGENT][NEUTRAL] Hi, [PII]. Happy to check eligibility and benefits. What is the patient's policy number?
[CUSTOMER][NEUTRAL] The patient's policy number is 014.
[CUSTOMER][NEUTRAL] 58868 ML 8.
[AGENT][NEUTRAL] Thank you. And then if I could get the patient name and date of birth?
[CUSTOMER][NEUTRAL] So the patient's name is going to be um [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. So, patient is active. The effective date on this plan is [PII].
[AGENT][NEUTRAL] We are the members secondary insurance, so this is gonna cover deductible, co-pay, co-insurance of the primary does not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that's pretty much all I need then?
[AGENT][NEUTRAL] Yeah, did you, are they being seen in an outpatient basis inpatient?
[CUSTOMER][NEUTRAL] It's um uh for the emergency room I believe it's outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So they do have a benefit limit. The outpatient benefit max for the calendar year is gonna be $2000.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And it looks like they've not used anything.
[CUSTOMER][NEUTRAL] Is that like is that the.
[CUSTOMER][NEUTRAL] Is that the deductible or?
[AGENT][NEUTRAL] No, we're the secondary insurance, so we pick up deductible, co-pay or co-insurance from the primary.
[CUSTOMER][NEUTRAL] Oh OK OK sorry.
[CUSTOMER][NEUTRAL] OK, but you're saying that the outpatient benefit limit is 2000 and they haven't met any yet.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Anything else I can check on?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] No, that's it. Do you have a reference number for the call?
[AGENT][NEUTRAL] Yeah, absolutely. Call references my name with my last initial in today's date. My name is [PII], that's [PII] and last initial is [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, and then today's date.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Have a great day.
[CUSTOMER][POSITIVE] Thank you you too have a great day bye bye.
[AGENT][NEUTRAL] Bye bye.