AccountId: 011433970860
ContactId: 128317aa-77d5-4d62-b36b-196d517a2f78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 373450 ms
Total Talk Time (AGENT): 188243 ms
Total Talk Time (CUSTOMER): 209870 ms
Interruptions: 4
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/128317aa-77d5-4d62-b36b-196d517a2f78_20250617T14:47_UTC.wav
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[AGENT][NEUTRAL] Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a provider's office. A patient just provided a POS for secondary insurance, so I'm just trying to get eligibility and benefits for her.
[AGENT][NEUTRAL] OK. And did you say your name is [PII]?
[CUSTOMER][NEUTRAL] It's [PII]. It's [PII].
[AGENT][NEUTRAL] [PII], is that correct? OK, [PII], I'm so sorry. I just miss, I just misheard what you said. Um, and you're just needing
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] No, it's OK it happens all the time, [PII].
[AGENT][NEUTRAL] Well, I understand that kind of because [PII], I spell [PII] different a little differently than most people, so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh nobody ever gets my name right either, so I, I understand that. Um and if you need, my name is spelled [PII]
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, [PII], so you're needing to get eligibility and benefits for members, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] It is 02559424 M as in Mary, L as in love 8.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Um, to, to, to [PII], yeah, do you have, do you have like an early out, um, um, we do, we do, uh, we offer 20%.
[CUSTOMER][NEUTRAL] And um we also have a project that we do want the uh where we operate in a deeper.
[CUSTOMER][NEGATIVE] So they don't wind up in just that debt.
[AGENT][NEUTRAL] And talk to any information that I do provide today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] For quite a few years now, so like I, I, and sometimes that helps and the the.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] It would be for outpatient services.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That that's in line with this number here. That's not you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I guess the question is do we want to revisit doing that full since we're getting close you doing the like ARC.
[AGENT][NEUTRAL] OK, so on her outpatient benefits, the outpatient benefit maximum per calendar day for covered outpatient services is $1000.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][POSITIVE] Perfect and let me.
[AGENT][NEUTRAL] Now, because this is a.
[AGENT][NEUTRAL] Oh, I'm sorry, [PII], go ahead. I was just gonna give you a couple of additional pieces of information. OK, so because it is a supplemental plan to her primary insurance, when the claim is filed with APL, we will have to also have a copy of her primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm. No, no, no, go ahead.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once the claim has been processed by us we do have a portal that you should be able to check claim status in and the website for our portal copy is secured.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Am public.
[CUSTOMER][NEUTRAL] they were
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. And let me see here and lastly for this patient and [PII], can I have a reference number please?
[AGENT][NEUTRAL] Sure, you're gonna use my name along with today's date.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][POSITIVE] Perfect and I do have one last patient if you don't mind just checking if her policy is active.
[AGENT][POSITIVE] OK, so you're needing, you have one more member or one more that you need to check? OK, that's fine. Well just give me one second. I'll be happy to look that one up for you.
[CUSTOMER][POSITIVE] Yeah, I just found it. Yes.
[CUSTOMER][NEUTRAL] People
[CUSTOMER][POSITIVE] No problem, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK yeah.
[AGENT][NEUTRAL] OK, and what is the next member's policy number?
[CUSTOMER][NEUTRAL] Her policy number is 02212777 M as in Mary, L as in love 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Uh, because it was previously done by uh uh and uh.
[CUSTOMER][NEUTRAL] In the original, but um when we learned that it wasn't then we kind of took over.
[AGENT][NEUTRAL] And the same with this when any information provided is a verification of benefits and not a guarantee of payment. What is this patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is the subscriber also on the supplemental policy and it is active as well. This one is effective, has an effective date of [PII].
[CUSTOMER][NEUTRAL] Looking at how
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Perfect and reference number same correct? Just your name in today's date?
[AGENT][NEUTRAL] Uh, that is correct. Just name it is.
[CUSTOMER][POSITIVE] Alrighty perfect thank you so much [PII] you were a great help.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] OK, well, it was my pleasure in speaking to you today, [PII], and I hope you have a wonderful day and thank you again for calling APL.
[CUSTOMER][POSITIVE] Likewise you have a good one.
[AGENT][POSITIVE] Yes, ma'am. Thank you. You too.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] To.