AccountId: 011433970860
ContactId: 0a517934-5ce2-4ab8-8307-a79ef79951ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188990 ms
Total Talk Time (AGENT): 103180 ms
Total Talk Time (CUSTOMER): 43194 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/0a517934-5ce2-4ab8-8307-a79ef79951ad_20250529T19:01_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] Hey, I was just calling to verify patients insurance eligibility and benefits.
[AGENT][NEUTRAL] OK, you're needing eligibility and benefits for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII] Last name initial is [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], thank you. And your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] It is 02587943.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] And any information that I do provide for you today will 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] Uh, [PII], date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And again, [PII], any information that is provided will be a verification of benefits and not a guarantee of payment. So I do show that Ms. [PII] is a dependent on this limited benefit plan and yes ma'am, it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefit information do you need on this limited policy? Inpatient, outpatient, or all?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we're um
[CUSTOMER][NEUTRAL] We're a PCP, the PCP office.
[AGENT][NEUTRAL] OK, so on this limited benefit plan, the outpatient accident and sickness treatment benefits for physician's office visit is $75 per day, with a maximum of 6 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once the claim has been processed, if you all end up filing a claim with us, [PII], once it has been processed here, we do have a portal that you all should be able to check the claim status in, and the website that you would go to for that is located at [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you only pay 75 6 days per account, OK, and um can I get your name please?
[AGENT][NEUTRAL] Again, my name is [PII] and you would use my name along with today's date if you need a call reference number.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][POSITIVE] Well, you're very welcome. And can I help you with anything else?
[CUSTOMER][NEUTRAL] No, that was all.
[AGENT][POSITIVE] OK [PII], well thank you for calling APL and I hope that you have a nice afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Yes ma'am, bye bye. Thank you.