AccountId: 011433970860
ContactId: fc05f373-2253-4c4e-8843-cc725365fac6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195009 ms
Total Talk Time (AGENT): 99122 ms
Total Talk Time (CUSTOMER): 47336 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/fc05f373-2253-4c4e-8843-cc725365fac6_20250523T15:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. I'm with uh Baptist Health Group. I'm uh calling to find benefits for a patient that's currently being seen at urgent care.
[AGENT][NEUTRAL] OK, and you said your name is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you're needing eligibility and benefit information for a member, is that correct, [PII]?
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with those things and what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] It is 02580212 ML 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. Now, on his insurance, it is just listed as [PII].
[AGENT][NEUTRAL] Just so that you know.
[CUSTOMER][NEUTRAL] OK, yeah, [PII] is the other, yeah, OK.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on the supplemental policy and yes, it is active, [PII], with an effective date of [PII].
[AGENT][NEUTRAL] And the outpatient benefit maximum is a per calendar day benefit, so it is a $500 per calendar day max for covered outpatient services with no deductible.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] You're welcome. And then when the claim is submitted to APL for review.
[AGENT][NEUTRAL] We will have to have a copy of the primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we've processed the claim here we have a portal [PII] that you all should be able to check claim status in.
[AGENT][NEUTRAL] And the website for our portal is located at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. [PII]. OK, got it.
[AGENT][NEUTRAL] That's it. Yes, ma'am.
[CUSTOMER][POSITIVE] Thank you so much. I hope you have a great day.
[AGENT][POSITIVE] Well, I hope you have a great day too, [PII], and that is all I can help you with, thank you again for calling APL and I also hope you have a wonderful holiday weekend.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][POSITIVE] Uh-huh, thank you too.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.