AccountId: 011433970860
ContactId: 010f084a-b060-4057-bfd5-91ee2da44476
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352029 ms
Total Talk Time (AGENT): 167603 ms
Total Talk Time (CUSTOMER): 106284 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/010f084a-b060-4057-bfd5-91ee2da44476_20250304T13:11_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I just need to verify a patient's benefits.
[AGENT][NEUTRAL] OK, you already have eligibility. You only need benefit information, is that correct?
[CUSTOMER][NEUTRAL] Um, well, both will be fine too.
[AGENT][POSITIVE] OK, yes ma'am, I can help you with that and who am I speaking with?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] 02582916
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And this is on a dental policy, is that correct, Morgan?
[CUSTOMER][NEUTRAL] That's what I wanted to verify because I know it says group voluntary dental but it's only dental.
[AGENT][POSITIVE] This is gentle.
[AGENT][NEUTRAL] Yes, ma'am, this is a, this is only a dental policy. Yes, ma'am. Are you not needing dental benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, ma'am, I need medical.
[AGENT][NEUTRAL] Uh, let me see if they have a medical.
[CUSTOMER][NEUTRAL] Yes ma'am. [PII] correct.
[CUSTOMER][NEUTRAL] You can come at any you can come at any time from [PII] and they go to.
[CUSTOMER][NEUTRAL] 3 minutes.
[CUSTOMER][POSITIVE] I got you
[CUSTOMER][NEUTRAL] [PII]. You're welcome, ma'am.
[AGENT][NEUTRAL] Uh, bear with me just a moment because now my.
[CUSTOMER][NEUTRAL] Uh sales.
[AGENT][NEGATIVE] Screen is stuck. Hm, sorry.
[CUSTOMER][POSITIVE] Oh, you're good. You're fine.
[CUSTOMER][NEUTRAL] order.
[CUSTOMER][NEUTRAL] Trying to be so I'm going in here.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I mean, honestly, I mean.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] So this part
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] And he needs to go ahead and go get his X-ray or whatever.
[AGENT][NEUTRAL] Almost there, [PII].
[CUSTOMER][POSITIVE] You're good you're good.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] you can have a.
[AGENT][NEUTRAL] OK, [PII], any information that I do provide for you today?
[AGENT][NEUTRAL] Will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Um, it's [PII] and it's [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is the subscriber on this limited benefit plan. This is not major medical insurance. It is a hospital indemnity limited benefit plan. Uh, the policy is active as of [PII].
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] you know with the.
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Office visit.
[AGENT][NEUTRAL] OK, so on this policy, the, for accident and sickness treatment, the physician's office benefit is $100 per day.
[AGENT][NEUTRAL] And a maximum of 4 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK and then is that ID number the same as the dental policy ID?
[AGENT][NEUTRAL] No, I'm going to give, no, it is not. Her medical ID number is [PII].
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, and are those claims still sent to the payer ID 60801?
[AGENT][NEUTRAL] No, ma'am, they are not. The so she should have a completely different card for this plan. Mhm. So the um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Different card, yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The claims payer ID for this is gonna be 64556.
[AGENT][NEUTRAL] And the correct mailing address is will be sent to IMA.
[AGENT][NEUTRAL] And that is at [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Now once the claim has been processed, [PII], we do have a portal here at APL in which you should be able to check claim status by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] OK. And is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] Um, I think that's all if I can just get a reference number.
[AGENT][NEUTRAL] Yes, and you would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK, all right, thank you so much, [PII].
[AGENT][POSITIVE] OK. Well, you're very welcome, [PII] and thank you again for calling APL. I hope that you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.