AccountId: 011433970860
ContactId: 071be48a-4688-4e0a-8086-29807387b332
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248399 ms
Total Talk Time (AGENT): 96783 ms
Total Talk Time (CUSTOMER): 98888 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/071be48a-4688-4e0a-8086-29807387b332_20250107T21:52_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. Um, I need to verify benefits for a patient, please.
[AGENT][NEUTRAL] OK, I can help you with the benefits and verifying and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEGATIVE] Um, the policy number I have is kind of small. There's something wrong with this number.
[CUSTOMER][NEUTRAL] Uh, they only put 60801. I know with you guys it's longer, right?
[AGENT][NEUTRAL] Oh yeah, that's our payer ID. Yes.
[CUSTOMER][NEGATIVE] Oh no.
[AGENT][NEUTRAL] Do you have the member's social or first and last name I can search by?
[CUSTOMER][NEUTRAL] Yes, please. Uh the last name is [PII]
[CUSTOMER][NEUTRAL] And the first name is [PII], I cannot even pronounce, [PII].
[AGENT][NEUTRAL] OK. WE
[CUSTOMER][NEUTRAL] Well, what's the list?
[AGENT][NEUTRAL] Wait, can you spell that one more time?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So I'm just waiting for the policies to populate here.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Just a group number I don't know if that helps.
[AGENT][NEUTRAL] Oh, yes. What's the group number?
[CUSTOMER][NEUTRAL] 80106.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Oh, well, actually the policy just popped up. Hold on one second.
[CUSTOMER][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] And can you verify the member's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, it's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, that's for, um, MRI, but I, I need to, the policy number, please, the insurance number.
[AGENT][NEUTRAL] It's 256.
[AGENT][NEUTRAL] 572 7.
[CUSTOMER][NEUTRAL] It doesn't require MLL 8, no, it doesn't require that information.
[AGENT][NEUTRAL] Oh, no, that's just on the card, so you can decide for between inpatient and outpatient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, you guys were closed when the patient came back on [PII]. Um, we just wanna know that he, he, he was active for that day of services.
[AGENT][NEUTRAL] Yes, the policy is, yes, the policy has been active since [PII] of last year.
[CUSTOMER][POSITIVE] OK, perfect. And
[AGENT][NEUTRAL] So it was active in December.
[CUSTOMER][NEUTRAL] OK, and what's the benefits and the accumulation?
[AGENT][NEUTRAL] For outpatient, the benefit is up to $750 per calendar day, so it resets daily.
[CUSTOMER][POSITIVE] All right, perfect.
[CUSTOMER][NEUTRAL] OK, and no authorization is required, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, um, can I have a reference number please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is L as in Larry.
[CUSTOMER][NEUTRAL] And your first name is [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Perfect, thank you, really appreciate your help.
[AGENT][NEUTRAL] You're very welcome. You're welcome. And again, all the information provided was a verification of benefits, not a guarantee of payment. And [PII], was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, that will be all. I appreciate your help.
[AGENT][POSITIVE] Alright. You're welcome. Thanks for calling APL and [PII].
[CUSTOMER][POSITIVE] [PII] to you too, take care bye.
[AGENT][POSITIVE] Thank you.