AccountId: 011433970860
ContactId: 209d31fc-5d89-45aa-87d0-20d656c35dee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236779 ms
Total Talk Time (AGENT): 124338 ms
Total Talk Time (CUSTOMER): 42930 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/209d31fc-5d89-45aa-87d0-20d656c35dee_20250328T14:51_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] Hey [PII], um, my name is [PII]. I'm calling from Thomasville Center.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I need to I need to verify benefits for a patient.
[AGENT][NEUTRAL] OK, [PII], you're needing to verify benefits only. Do you also need eligibility?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And what is a good callback number for you, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] 02603663
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][NEUTRAL] Yes ma'am.
[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, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on this limited benefit plan and this policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And again this is not major medical insurance, it is a limited benefit plan. So what type of benefit information are you needing? inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Office specialist.
[AGENT][NEUTRAL] Office specialist, OK. Um, for an office visit, the benefit on this plan is $100 per day, maximum of 4 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] 100
[AGENT][NEUTRAL] Mhm. Per day.
[CUSTOMER][NEUTRAL] Per day.
[AGENT][NEUTRAL] Maximum of 4 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] Has she used any yet?
[AGENT][NEUTRAL] I can check that for you, just one moment.
[AGENT][NEUTRAL] Uh, no, ma'am. As of now, she has not used any of her benefits for that.
[AGENT][NEUTRAL] Now once if you end up filing a claim with us, uh, [PII] for this member, once the claim has been processed, we do have a portal in which you should be able to check claim status and the portal website for us is [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] All right
[AGENT][POSITIVE] OK. Well, is there anything? You are certainly welcome.
[CUSTOMER][POSITIVE] Alright, that sounds great thank you.
[CUSTOMER][NEUTRAL] No ma'am, that is it.
[AGENT][POSITIVE] OK, well if that's all I can help you with today then thank you again for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] May I get a reference number there?
[AGENT][NEUTRAL] Sure, you would use my name along with today's date.
[CUSTOMER][POSITIVE] All right thank you and you have a great day too.
[AGENT][POSITIVE] You, yes, ma'am. Thank you so much.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Papa.
[CUSTOMER][NEUTRAL] OK