AccountId: 011433970860
ContactId: 27e2cc98-55e9-40ee-a0fc-145463138224
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209750 ms
Total Talk Time (AGENT): 106106 ms
Total Talk Time (CUSTOMER): 33813 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/27e2cc98-55e9-40ee-a0fc-145463138224_20250428T16:58_UTC.wav
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[AGENT][POSITIVE] Good Morning. Excuse me, good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I'm calling from a provider's office. I need to verify benefits for a patient, please.
[AGENT][NEUTRAL] OK, [PII], you're needing benefits only or do you also need eligibility?
[CUSTOMER][MIXED] Only benefits
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is your callback number please [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] 02249239
[AGENT][NEUTRAL] Thank you one moment while I get the information pulled up please.
[AGENT][NEUTRAL] And [PII], any information provided will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what type of benefit information on this supplemental policy do you need inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] It's still loading [PII], give me just a moment please.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so on this excuse me, on this supplemental policy, the outpatient benefit maximum is $500 per covered person per occurrence and there is no outpatient deductible per covered person per occurrence.
[CUSTOMER][NEUTRAL] OK perfect can I have a call reference number please?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Sure, you will actually use my name that I gave you along with today's date and just a couple of additional things for you, [PII]. When the claim is submitted to APLs for review, we will also have to receive a copy of his primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check the claim status for us and that website is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] All right. Well, is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No, that's all for today, [PII] thank you so much.
[AGENT][POSITIVE] OK. Well, you're very welcome and thank you for calling APL. I hope you have a great afternoon.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.