AccountId: 011433970860
ContactId: 0d0768f9-9d53-41dd-91cb-cd3a40f44511
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161559 ms
Total Talk Time (AGENT): 64149 ms
Total Talk Time (CUSTOMER): 93819 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/0d0768f9-9d53-41dd-91cb-cd3a40f44511_20250416T14:38_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, um, my name is [PII]. I'm calling from an ambulatory surgical facility, and I was trying to verify eligibility and benefits for one of your insured.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Uh, callback number is [PII].
[CUSTOMER][NEUTRAL] And the policy number, hold on, is it the payer ID up on the top right of the corner?
[AGENT][NEUTRAL] No it should say policy or certification number, certain number.
[CUSTOMER][NEUTRAL] Oh, OK, uh, outpatient benefit certification number.
[CUSTOMER][NEUTRAL] Um, 024731.
[CUSTOMER][NEUTRAL] 72 M like Mary.
[CUSTOMER][NEUTRAL] L like love 8.
[AGENT][POSITIVE] Thank you. And you said your name was [PII], correct?
[CUSTOMER][NEUTRAL] Yes ma'am, what was your name again? I'm sorry.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Uh, name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] You're calling to verify outpatient benefits. This policy has been active since.
[AGENT][NEUTRAL] [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, [PII], and does she have available benefits like, uh, does she get reimbursed or do you guys cover, uh, deductibles?
[AGENT][NEUTRAL] So this policy is a gap insurance, you'll have to send in the um primary EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we could, we, um, assist with deductible co-pay and co-insurance. She has outpatient benefits of $300 per calendar day and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK great so she would have to, she gets reimbursed from you guys.
[AGENT][NEUTRAL] No, you can submit a claim here as a secondary insurance, yes, because this is her secondary insurance, but we would need the primary EOB.
[CUSTOMER][NEUTRAL] Oh, we would send it to you guys. Oh, OK, got you, got you, got you, got you, got you, got you, got you, got you. OK, so $300 OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And let's see what else do I need? What else do I need? What else do I need? I think that's it. I just needed a reference number then.
[AGENT][NEUTRAL] We don't provide those [PII], however, you can use my name in today's date as a reference. My name is [PII], and today's date.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And today's date and the claims go to the [PII]?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help.
[AGENT][POSITIVE] You're welcome thanks for calling APL. Have a good day. Goodbye.
[CUSTOMER][POSITIVE] Have a great one.
[CUSTOMER][NEUTRAL] You too bye bye.