AccountId: 011433970860
ContactId: 2ed84713-9755-414e-aa1f-4ca4d3c48ade
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254830 ms
Total Talk Time (AGENT): 125977 ms
Total Talk Time (CUSTOMER): 47979 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/2ed84713-9755-414e-aa1f-4ca4d3c48ade_20250305T19:13_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi. I'm calling because I need to verify eligibility for a patient.
[AGENT][NEUTRAL] OK, you only need eligibility. You do not need benefits, is that correct?
[CUSTOMER][NEUTRAL] Um, I guess if I can get both.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] I have 2408052.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[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?
[CUSTOMER][NEUTRAL] It's for [PII], um, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So I do show that she is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And on the supplemental policy, what type of benefit information do you need for her, [PII], inpatient, outpatient or office?
[CUSTOMER][POSITIVE] Uh, impatient.
[AGENT][NEUTRAL] Inpatient, OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so she, on this, um, excuse me, on this supplemental policy, the inpatient benefit maximum per calendar year is $1500.
[AGENT][NEUTRAL] And there is no inpatient deductible per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK. And um you said it's a supplement, so you're secondary to uh
[AGENT][NEUTRAL] Yes ma'am, we would be secondary to her primary insurance.
[CUSTOMER][NEUTRAL] OK and uh where do we send our claims to?
[AGENT][NEUTRAL] The claims will be sent to [PII].
[AGENT][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] And because this is a supplemental policy, [PII], when the claim is submitted to APL for review, we will also need a copy of her primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK, and does this policy have a group number?
[AGENT][NEUTRAL] And then once we're
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] The group number is 21302.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then also once we have processed the claim at APL we do have a portal in which you should be able to check claim status and the website for our portal is at [PII].
[CUSTOMER][NEUTRAL] OK. All right. And
[AGENT][NEUTRAL] Is there anything else, [PII] I can help you with?
[CUSTOMER][NEUTRAL] Um, do you have a reference code number by any chance?
[AGENT][NEUTRAL] You would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK, sounds good. Thank you. You have a good rest of your day.
[AGENT][POSITIVE] Well, [PII], I hope you do too, and thank you again for calling ATL.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.