AccountId: 011433970860
ContactId: 1a8e817d-611a-452a-8950-b3a15f58b71e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 366769 ms
Total Talk Time (AGENT): 119797 ms
Total Talk Time (CUSTOMER): 117726 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/1a8e817d-611a-452a-8950-b3a15f58b71e_20250505T19:17_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] checking on patient eligibility.
[AGENT][NEUTRAL] OK, spell your first name for me?
[CUSTOMER][NEUTRAL] It's [PII]. OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Got it and you said that you're needing benefit information?
[CUSTOMER][NEUTRAL] Yes, eligibility.
[AGENT][NEUTRAL] Is this for service in a doctor's office or is it outpatient facility hospital?
[CUSTOMER][NEUTRAL] The facility calling from the facility.
[AGENT][NEUTRAL] OK. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 01988239 M as in Mike L as in Lima 7.
[AGENT][NEUTRAL] OK, and what's a good callback number in just in case we're disconnected?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And um can you verify the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Yes, the patient's first name is [PII] and the last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you. I have the information for you. I'm showing an effective date of [PII]. Uh, the policy is active.
[AGENT][NEUTRAL] And I do show the maximum.
[CUSTOMER][NEUTRAL] Still active, there is no termination date.
[AGENT][NEUTRAL] The policy is active.
[AGENT][NEUTRAL] That means it's not termed, it's active.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Um, I do show that the max.
[CUSTOMER][NEUTRAL] All right, what is the payer ID?
[AGENT][NEUTRAL] OK, let me go ahead and provide you the benefits first, OK? And then we'll move to the next question.
[AGENT][NEUTRAL] So I showed the maximum.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Outpatient benefit is up to $500 that's per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And information provided is verification. It does not guarantee payment of a claim. And are you ready for the payer ID number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] And what is the mailing address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 950, OK.
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The state is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The zip code?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. And what is the plan type?
[AGENT][NEUTRAL] It's a supplemental, it's a gap policy.
[CUSTOMER][NEUTRAL] Gap policy.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, one moment. All right. What is the timely filing limit?
[AGENT][NEGATIVE] To submit a claim there is no timely.
[CUSTOMER][NEUTRAL] OK. What is the call reference number, [PII]?
[AGENT][NEUTRAL] My name, my name in today's date, [PII], and any other questions?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, yes, I do have one more patient. Could you please help me with that?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] OK. Take your time.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Straw
[CUSTOMER][NEUTRAL] Small, medium, large.
[CUSTOMER][NEUTRAL] Give me
[CUSTOMER][NEUTRAL] All right, sir. We move to the next one.
[AGENT][NEUTRAL] Uh, one moment please.
[CUSTOMER][POSITIVE] All right. Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, and I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] Yes, the next policy number is 02249239.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's first name is [PII], and the last name is [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. The policy effective date is [PII].
[AGENT][NEUTRAL] Policy is active.
[CUSTOMER][NEUTRAL] September, right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Policy is active?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The maximum outpatient benefit?
[AGENT][NEUTRAL] is up to $500 per occurrence.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] All right. And the payer ID mailing address is the same one, right, which you have given the earlier?
[AGENT][NEUTRAL] It's the same.
[AGENT][NEUTRAL] Mhm. It is the same.
[CUSTOMER][NEUTRAL] All right. And the call reference number also is the same, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] All right. Thank you so much, [PII].
[AGENT][POSITIVE] You're welcome, [PII], and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Mhm.