AccountId: 011433970860
ContactId: 0f212b81-bc87-4a99-9728-8337f8e09f31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278929 ms
Total Talk Time (AGENT): 152408 ms
Total Talk Time (CUSTOMER): 90968 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/0f212b81-bc87-4a99-9728-8337f8e09f31_20250212T20:47_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] We need to verify benefits please.
[AGENT][NEUTRAL] OK, you're only needing benefit information or do you also need eligibility as well?
[CUSTOMER][NEUTRAL] Well, I don't need to know if they're eligible.
[AGENT][POSITIVE] Yes, I can help you with both of those things.
[CUSTOMER][POSITIVE] And also and and benefits, yes, both.
[AGENT][POSITIVE] Yes, ma'am, I can help you with those. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][POSITIVE] Thank you. And what is a good callback number for you please, [PII]?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] I have 01433096 M as in Mary L 8.
[AGENT][NEUTRAL] OK, thank you. One moment, [PII] while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today 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] Uh, [PII] Grave date of birth is um [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I do show, and again, any information that I provide for you, [PII] would be a verification of benefits and not a guarantee of payment. I do show that he is a dependent on the supplemental policy, and the supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And what type of benefit information are you needing inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um, well
[CUSTOMER][NEUTRAL] How patient
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this policy, there is an outpatient benefit maximum of $500 per covered person per calendar day for covered outpatient services, and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Because this is a supplemental policy, [PII], to their primary insurance when the claim is submitted to APL for review, we will also.
[AGENT][NEUTRAL] Have to have a copy of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And then once we have reviewed the claim and processed it, we do have a portal that you should be able to check claim status and also have access to our EOB and our portal website is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so is this, is this part of any network or no you just pay.
[AGENT][NEGATIVE] No, ma'am, it is not. There is no network with this policy.
[CUSTOMER][NEUTRAL] It should you pay
[CUSTOMER][NEUTRAL] OK, so if the primary insurance company pays and they, you know.
[CUSTOMER][NEUTRAL] Have
[CUSTOMER][NEUTRAL] First it's gonna go through their insurance. I understand the primary insurance and you just pay our charges, is that what it is? What's left?
[AGENT][NEUTRAL] This policy is designed to help with their co-pays, deductibles, and co-insurance amounts of coverage services up to that benefit maximum.
[CUSTOMER][POSITIVE] Um, to the max, OK, great, and, and no what's required, right? And, and.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[AGENT][POSITIVE] Correct, that is correct.
[CUSTOMER][NEUTRAL] And does the uh claim go to American Public Life [PII]?
[AGENT][NEUTRAL] [PII]. That is correct.
[CUSTOMER][NEUTRAL] [PII] OK and then.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Other questions, let me see.
[CUSTOMER][NEUTRAL] I have everything there, the phone number and all that.
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][POSITIVE] Um, OK, alrighty, that's all I need. Thanks so much. And what was your name?
[AGENT][NEUTRAL] Alright, well again my name is [PII] and if you need a call reference number for our call today [PII], you would just use my name along with today's date.
[CUSTOMER][POSITIVE] Date [PII] and the date. OK, alright, thank you very much.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Well, you are certainly very welcome and if that's all I can help you with, thank you again for calling APL and I hope you have a nice evening.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Sure thank you bye bye.
[AGENT][NEUTRAL] Yes, ma'am. Bye bye.