AccountId: 011433970860
ContactId: 2fa5d85a-677a-4f64-ac0a-7455f5b9618d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226699 ms
Total Talk Time (AGENT): 118744 ms
Total Talk Time (CUSTOMER): 47789 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/2fa5d85a-677a-4f64-ac0a-7455f5b9618d_20250509T20:13_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling to verify benefits for a patient.
[AGENT][NEUTRAL] OK, [PII], you're only needing benefits. You do not need eligibility, is that correct?
[CUSTOMER][NEUTRAL] Uh, yeah, I'll take eligibility as well.
[AGENT][POSITIVE] Yes ma'am, I can help you with those, and [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII] option one.
[AGENT][NEUTRAL] Thank you and what is the member's policy number please?
[CUSTOMER][NEUTRAL] I have a 02515502.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And information [PII] that I provide for you 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] This is for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, so she is a subscriber, [PII], and again, any information provided will be a verification of benefits and not a guarantee of payment, but she is the subscriber on this plan, and this supplemental policy 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] Outpatient please.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So she has an outpatient benefit maximum per calendar day for covered outpatient services in the amount of $500 and there is no deductible for outpatient per covered person per calendar day.
[CUSTOMER][NEUTRAL] Alright, so she's covered $500 per day. All right. OK, then.
[AGENT][POSITIVE] That is correct. Now, because this is a, oh, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh no, I, I was just gonna say that's all I needed.
[AGENT][NEUTRAL] Oh, OK, so just a couple of additional pieces of information for you, [PII], because this is a pri supplement to her primary insurance when the claim is submitted to APL for review, we must also receive a copy of her primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we've processed the claim here at APO we do have a portal that you should be able to check the claim status in and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK, alright then, well, if that is all I could help you with today, [PII], thank you for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Yeah you too if I could also just have the initial to your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much for your help, [PII] you have a wonderful rest of your day.
[AGENT][POSITIVE] Well, I hope you do too, [PII], thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.