AccountId: 011433970860
ContactId: 06ffbf03-bf95-4d55-8274-63a139b85206
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201009 ms
Total Talk Time (AGENT): 102977 ms
Total Talk Time (CUSTOMER): 68297 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/06ffbf03-bf95-4d55-8274-63a139b85206_20250331T14:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? My name is [PII] and I'm calling to verify members' eligibility as well as all requirements and benefits.
[AGENT][NEUTRAL] Sure, I can check all of that for you eligibility benefits and if authorization is required. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02543182 M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] OK, I apologize, could you repeat that for me, [PII]?
[CUSTOMER][NEUTRAL] Sure, of course. 02543182 ML 8.
[AGENT][NEUTRAL] OK, thank you. I missed that 8. Give me just a moment.
[AGENT][NEUTRAL] Alrighty and then what was the name and date of birth for the member please?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pay. So this plan is very, uh, reliant on major medical, so as long as they're willing to pay this policy can so of course no authorization is required and what we need to look at uh inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] It'd be outpatient.
[AGENT][NEUTRAL] Outpatient, OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So their outpatient benefit is on a per calendar day basis. It pays up to $1000 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. And just to confirm, can I verify the claims address with you? I have here [PII] [PII].
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] That is correct. Um, I've also got a fax number and a payer ID if you'd like.
[CUSTOMER][POSITIVE] Perfect. Great. Thanks.
[AGENT][NEUTRAL] Of course, so that fax number is 877.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, I have [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Thanks and the payer ID?
[AGENT][NEUTRAL] That is 60801.
[CUSTOMER][POSITIVE] 60801. Perfect.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, was there anything else I can help you with [PII]?
[CUSTOMER][POSITIVE] Awesome thank you so very much. Is there a call reference number?
[AGENT][NEUTRAL] Sure, that would just be.
[CUSTOMER][NEUTRAL] Um, no, not at this time as well.
[AGENT][NEUTRAL] Yes, uh, reference number would just be, uh, first, my first name, last initial, and today's date. Uh, so my name is spelled [PII] last initial is A.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][POSITIVE] Perfect thank you very much for your time and happy Monday.
[AGENT][POSITIVE] Of course thank you have a great day.
[CUSTOMER][POSITIVE] Thanks. You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.