AccountId: 011433970860
ContactId: f9bdf253-bf7c-4ecb-8ab8-842af00889f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279130 ms
Total Talk Time (AGENT): 103361 ms
Total Talk Time (CUSTOMER): 71311 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/f9bdf253-bf7c-4ecb-8ab8-842af00889f9_20250404T16:17_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I'm sorry, you said [PII]?
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling from Baptist Outpatient. I needed to check on a member's benefits and eligibility for outpatient services.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, [PII], I can help you with benefits and eligibility. Could I get a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the policy number of the patient?
[CUSTOMER][NEUTRAL] It is 0255948.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And patient name and date of birth.
[CUSTOMER][NEUTRAL] Yes. The patient's name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is that L [PII] O?
[CUSTOMER][NEUTRAL] L [PII] G O.
[AGENT][NEUTRAL] OK, uh, could you give me that um policy number one more time? I'm so sorry.
[CUSTOMER][NEUTRAL] I have 0255948.
[AGENT][NEUTRAL] OK, I think we're missing a 5. Hold on just a second. I've got.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] I've got 255-5948.
[CUSTOMER][NEUTRAL] OK. 2555 948 with a 0 on the front?
[AGENT][NEUTRAL] Uh, yeah, the 0 doesn't matter.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I was missing a 5. I'm sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get her benefits pulled up, and this is not a guarantee of payment, it's a basic outline of our policy, and were you needing outpatient benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, she's effective [PII]. The policy is active.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] So for her outpatient benefits, she has a $3000 calendar year maximum benefit.
[AGENT][NEUTRAL] Um, this is a secondary policy, so please be sure on file with the primary explanation of benefits.
[CUSTOMER][NEUTRAL] 3000 a year?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it covers diagnostic X-rays.
[AGENT][NEUTRAL] Um, looks like.
[AGENT][NEUTRAL] So, diagnostic testing performed at a hospital outpatient facility or MRI um facility or a physician's um office.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Wonderful. Now, question, have, I mean, this was effective 101, have they met the full 3000?
[CUSTOMER][NEUTRAL] Do you know what the remaining balance is?
[AGENT][NEUTRAL] Um, so that's, that's.
[AGENT][NEUTRAL] Um, so that's the payout amount. Let me see if they've used anything for this calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] So I don't sure if she's used anything so far this year. So basically, once primary processes the claim, this policy will pay up to 3000 of deductible co-insurance co-pays.
[CUSTOMER][POSITIVE] Wonderful. OK, Ms. [PII]. Any call reference number that you, I should write down?
[AGENT][NEUTRAL] Yeah, the call reference number is just my name, [PII], first initial of my last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much. You have a wonderful day.
[AGENT][POSITIVE] Thank you for calling APL. Have a great weekend.
[CUSTOMER][NEUTRAL] Bye bye.