AccountId: 011433970860
ContactId: 275c6b75-7a4a-4cb8-a11f-0f42f3097a93
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204289 ms
Total Talk Time (AGENT): 103699 ms
Total Talk Time (CUSTOMER): 56480 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/275c6b75-7a4a-4cb8-a11f-0f42f3097a93_20250411T12:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from orthopedic specialists at [PII]. I'm looking for eligibility and benefits for a patient, please.
[AGENT][NEUTRAL] OK. And you did say your name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, [PII], you said that you're needing eligibility and benefits for a member?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] Is that correct? Yes, ma'am. I can help you with that. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It is 01660260ML8.
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And [PII], any information that I do provide today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII] and date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] Sorry, I never bought anything else.
[AGENT][NEUTRAL] OK, so I do show he is a dependent on the supplemental policy 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 him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Office visit for specialist office please.
[AGENT][NEUTRAL] OK, so on the supplemental policy office visits are not covered. If he were to receive some form of treatment in the office, we could review the treatment for benefits, but the office visit itself is not covered.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK, so, um, [PII], can I just have a reference number?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[AGENT][NEUTRAL] And if you all should end up filing a claim [PII] with APL, we would have to have a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once our claims have been processed here, we do have a portal that you should be able to check our claim status in by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you so much you have a great day, [PII].
[AGENT][POSITIVE] Well, you're, yes ma'am you too and I thought, is there anything else first off that I could help you with?
[CUSTOMER][POSITIVE] No, that was it thank you so much.
[AGENT][POSITIVE] OK. All right. Well, you're welcome and thank you again for calling APL. Have a great weekend.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] You're welcome alright bye bye.
[AGENT][NEUTRAL] Bye-bye.