AccountId: 011433970860
ContactId: 1589a84e-1d01-46ec-af27-47361f74832d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242779 ms
Total Talk Time (AGENT): 137187 ms
Total Talk Time (CUSTOMER): 56033 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/1589a84e-1d01-46ec-af27-47361f74832d_20250428T16:30_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. My name is [PII]. I'm calling to verify uh patients benefits.
[AGENT][NEUTRAL] OK, [PII]. You do not need eligibility. You're only needing benefits. Is that correct?
[CUSTOMER][NEUTRAL] Um, I need the eligibility as well, thank you.
[AGENT][POSITIVE] OK, yes, ma'am. I can help you with those things. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]. There is no extension.
[AGENT][NEUTRAL] OK, thank you. And then [PII], what is the member's policy number, please?
[CUSTOMER][NEUTRAL] It's 02443376.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And [PII], again, any information provided 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] It's [PII], and date of birth on [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is a subscriber on this supplemental policy, [PII], and yes, ma'am, it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient, or office?
[CUSTOMER][NEUTRAL] Outpatient, she's scheduled for a colonoscopy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So she has an outpatient benefit max per calendar year for covered outpatient services of $1000.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar year.
[AGENT][NEUTRAL] Because this is a supplemental policy, Rachel, to her primary insurance company, uh, to her insurance company rather. When the claim is submitted to APO for review, we will have to have a copy of the primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check our claim status.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And our website for the portal is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You said [PII]?
[AGENT][NEUTRAL] There's a, uh, put a [PII] after the word [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] All right perfect and.
[AGENT][NEUTRAL] And as of now, she has not used any of her benefits for this calendar year.
[CUSTOMER][POSITIVE] Perfect. I was about to ask.
[AGENT][NEUTRAL] I figured you might be. OK. Well, is there anything else that I can help you with?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh, no, that was it. Can I have the first initial of your last name?
[AGENT][NEUTRAL] Yes, ma'am. It's [PII], and you would use my name, [PII], along with today's date as your call reference number.
[CUSTOMER][POSITIVE] Perfect thank you so much I appreciate your help.
[AGENT][POSITIVE] Well, you are very welcome and thank you for calling APL. I hope you have a wonderful rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you as well. Bye-bye.