AccountId: 011433970860
ContactId: 2394ab32-16bb-47a5-9403-82d70c082e4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256380 ms
Total Talk Time (AGENT): 130039 ms
Total Talk Time (CUSTOMER): 79649 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/2394ab32-16bb-47a5-9403-82d70c082e4b_20250606T16:28_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] OK, hi [PII], how are you doing? Good mor. Oh no, it's, it's afternoon now sorry.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Yeah, it's really close. I'm good. And yourself?
[CUSTOMER][POSITIVE] Good afternoon how are you doing?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Good. My name is [PII]. I work with Nicholas General Hospital in the authorization department. I need to verify gap benefits, gap coverage benefits for procedure that's gonna take place for a patient.
[AGENT][POSITIVE] Good.
[AGENT][NEUTRAL] OK, so you need, do you also need eligibility as well as benefits or just benefits?
[CUSTOMER][NEUTRAL] Yeah, yeah, eligibility, yeah, yeah, everything.
[AGENT][POSITIVE] OK, yes, I can help you with both. And if you could please give me your name again?
[CUSTOMER][NEUTRAL] [PII], [PII]
[AGENT][POSITIVE] OK, thank you. And what is a good callback number for you, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Um, it is 02481566.
[AGENT][NEUTRAL] OK, thank you [PII] one moment while I get the member's information pulled up.
[AGENT][NEUTRAL] And any any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do show that she is a dependent on the supplemental policy, [PII], and yes, 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] It
[CUSTOMER][NEUTRAL] Outpatient outpatient hospital.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank
[AGENT][NEUTRAL] So on the supplemental policy, the outpatient benefit maximum per calendar year for covered outpatient services per covered person is $3000 and there is no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] Alright got it and um.
[CUSTOMER][NEUTRAL] Um, right, that's it. I just need the.
[CUSTOMER][NEUTRAL] Your last name initial if you guys give it out and the and the reference number if you give the reference number.
[AGENT][NEUTRAL] Yes, the first initial to my last name is [PII]. My name in today's date will be your call reference number, [PII], and then just a couple of additional pieces of information for you because this is a supplement to the primary insurance. When the claim is submitted to us for review, we will also have to receive a copy of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] As well, 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 and the website that you would go to for that is secured.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, um, and one more thing I forgot to ask, uh, let me just double check on, on the PO box address.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII], it's [PII], [PII], [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. Yes, sir.
[CUSTOMER][POSITIVE] Yeah, [PII]. OK, perfect. Alright, cool. Alright, that's it. That's all I needed to know.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right. Well, if that's all I can help you with, and thank you for calling APL. I hope you have a great afternoon and a wonderful weekend.
[CUSTOMER][POSITIVE] You too have a great weekend bye bye.
[AGENT][POSITIVE] Thanks. Bye-bye.