AccountId: 011433970860
ContactId: fb2fc9dc-4ab5-4614-8a97-0face4bebc8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185179 ms
Total Talk Time (AGENT): 96972 ms
Total Talk Time (CUSTOMER): 58336 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/fb2fc9dc-4ab5-4614-8a97-0face4bebc8a_20250106T14:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning. I'm calling from Baptist Hospital of Miami to check patient eligibility, please.
[AGENT][NEUTRAL] OK, I can help you. What's the, um, your name and the policy number?
[CUSTOMER][NEUTRAL] My name is [PII], and the policy number is, yes.
[AGENT][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] And the policy number is 2576738.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], born [PII].
[AGENT][NEUTRAL] Thank you for that information and you're just checking the effective date and if the policy is active, [PII]?
[CUSTOMER][NEUTRAL] As well as his outpatient benefit amount, please.
[AGENT][NEUTRAL] Uh, when you say outpatient, is it in a hospital facility or a doctor's office?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Outpatient hospital facility.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I show the policy effective date is [PII]. This policy is active at this time, and give me one moment and I'll have the benefit information for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The maximum outpatient benefit is up to $7150 per calendar year and then there's also a $250 outpatient calendar year deductible excuse me, that needs to be satisfied as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, you said $200?
[AGENT][NEUTRAL] 250 and give me a second, let me verify if that's per calendar year or per outpatient service. Give me a second.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it is per calendar year. Oh, that's for, yeah for an accident or sickness, so it's up to $250 per calendar year.
[CUSTOMER][POSITIVE] OK, perfect. And has any of that been met so far?
[AGENT][NEUTRAL] For [PII].
[AGENT][NEUTRAL] One moment. No, I show no the deductible, the calendar your deductible has not been met and then the.
[CUSTOMER][NEUTRAL] Yes, for the deductible.
[AGENT][NEGATIVE] I'm sorry, the outpatient deductible has not been satisfied at this time.
[CUSTOMER][NEUTRAL] OK, and has any amounts been used out of the $7150?
[AGENT][NEUTRAL] No be no claims received for this patient.
[CUSTOMER][NEUTRAL] OK, understood alrighty and you said your name is [PII]?
[AGENT][NEUTRAL] Uh-huh. [PII] and you'll use my name in today's date as reference for today's call, [PII]. Any other questions?
[CUSTOMER][POSITIVE] No, that's gonna be it thank you so much for your help today.
[AGENT][POSITIVE] Oh, you're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.