AccountId: 011433970860
ContactId: 1b83d32d-b5c2-4039-bb4a-bff9462bfb48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358359 ms
Total Talk Time (AGENT): 172880 ms
Total Talk Time (CUSTOMER): 92432 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/1b83d32d-b5c2-4039-bb4a-bff9462bfb48_20250411T13:11_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] Hi, good morning. My name is [PII] from South Florida Dino Stain machine. Um, I need to verify benefits for a patient, please.
[AGENT][NEUTRAL] OK, [PII], do you need bene benefit information only, or do you also need eligibility and benefits?
[CUSTOMER][NEUTRAL] Um, yes, both.
[AGENT][NEUTRAL] Both? OK, so yes, ma'am, I can help you with that. And [PII], what is the callback number for you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The red line.
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Um, it seems too short. I'm not sure if this is correct.
[CUSTOMER][NEUTRAL] Uh, they put here 60801. That's very short for 8.
[AGENT][NEUTRAL] That's our electronic payer ID. Yes ma'am, that's our electronic payer ID.
[CUSTOMER][NEUTRAL] They didn't get the right information in scheduling. There's any way we can find it by the name and date of birth?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can't search by date of birth. Do you happen to have the full social security number?
[AGENT][NEUTRAL] For the subscriber?
[CUSTOMER][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] We, we don't collect that she haven't been here yet, so I have to wait until she comes to get more information.
[AGENT][NEUTRAL] I can try. I can try by the name [PII], if it's a very common name and I'm not able to locate it, then yes, I would have to have some additional information or, or her policy number. Again, that's 60801 is our electronic payer ID number.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Got you. I have the group number if that helps?
[CUSTOMER][NEUTRAL] Maybe it's correct. I'm not sure.
[AGENT][NEUTRAL] OK, what is the group number?
[CUSTOMER][NEUTRAL] I have here 17143.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] What is the patient's last name?
[CUSTOMER][NEUTRAL] [PII], which is [PII] [PII]
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] Uh the first name is uh [PII], which is [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today, [PII] would be a verification of benefits and not a guarantee of payment. What is her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So uh she is the subscriber on the supplemental policy.
[AGENT][NEUTRAL] The policy number that you should have is 02.
[AGENT][NEUTRAL] 59.
[AGENT][NEUTRAL] 53.
[AGENT][NEUTRAL] 46.
[AGENT][NEUTRAL] The policy 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] Uh
[CUSTOMER][NEUTRAL] Outpatient, yes, she's coming to do ultrasound, um, let me verify.
[CUSTOMER][NEUTRAL] Yeah, she's coming to do 2 ultrasounds.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So on the supplemental policy her outpatient benefit max per calendar day.
[AGENT][NEUTRAL] For covered outpatient services is $500.
[AGENT][NEUTRAL] And there is no outpatient deductible per cover person per calendar date.
[AGENT][NEUTRAL] Now because this is a supplement, yes ma'am, 500 per calendar day for covered services.
[CUSTOMER][POSITIVE] Perfect. You say 500 per day, right?
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] And then [PII] on this plan because it is a supplement to her insurance, when the claim is submitted to APL for review, we must also receive a copy of her primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] And then once we have processed our claim here we do have a portal in which you should be able to check claim status and our portal website is located at secured.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And is there anything else that I could help you with this morning, [PII]?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Um, no, I just need the.
[CUSTOMER][NEUTRAL] Uh, the reference number is, I'm, I'm I'm sorry I didn't catch your name either.
[AGENT][NEUTRAL] Reference number? Yes ma'am.
[AGENT][NEUTRAL] Use my name? You said you did not catch my name?
[CUSTOMER][POSITIVE] No, I didn't. I'm sorry if your voice comes and goes sometimes. I'm so sorry.
[AGENT][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And first initial to last name [PII].
[CUSTOMER][POSITIVE] OK, and today's day. OK, perfect. I appreciate your help.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Well, you're welcome, [PII]. It was my pleasure in helping you and thank you again for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] You too thank you