AccountId: 011433970860
ContactId: 07e32408-3e86-4a70-8e47-861887756484
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258040 ms
Total Talk Time (AGENT): 107193 ms
Total Talk Time (CUSTOMER): 56088 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/07e32408-3e86-4a70-8e47-861887756484_20250131T19:57_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling from an outpatient behavioral health clinic, and the client has presented this insurance, so I was calling to see if it was active and get benefit information.
[AGENT][NEUTRAL] OK [PII], so you're needing eligibility and benefit information, is that correct? Yes ma'am, I can help you with those things. And so first off, what is a good call back number for you please?
[CUSTOMER][POSITIVE] Yes ma'am, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 00990178.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And any information, [PII] that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that he is a subscriber on this policy and this policy is active, [PII]. This policy became effective [PII] and it is still active. Now, this is not a major medical plan. This is a limited benefit plan. So are you needing again inpatient, outpatient, or office benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, outpatient for, um, an office visit for behavioral health. Yes ma'am.
[AGENT][NEUTRAL] Office visit?
[AGENT][NEUTRAL] Alright, give me just a moment to get his policy information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Right, just a moment. It's just taking some time to lose.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No worries, my computer system is not the most cooperative either.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's writer for an office visit or yes, for treatment in the office. That benefit is $25 per day.
[AGENT][NEUTRAL] And a maximum of 5 days per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's for an outpatient office is correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, all right, thank you very much you have a good day.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Alright, well, you are starting there and one last thing if you all end up filing a claim with this [PII] on this policy, you can, um, we do have a portal that once we've processed the claim, you should be able to check claim status in and our portal website is secured.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Uh-huh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Oh OK well I will be sure to um include that to my um accounting office. Thank you very much.
[AGENT][POSITIVE] OK. All right. Well, thank you. And if that's all I can help you with, thank you again for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Thanks you as well bye bye.
[AGENT][POSITIVE] Thank you, bye-bye.