AccountId: 011433970860
ContactId: 38375532-4173-424d-9a1b-1bfc3b4bb23e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207070 ms
Total Talk Time (AGENT): 114721 ms
Total Talk Time (CUSTOMER): 48770 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/38375532-4173-424d-9a1b-1bfc3b4bb23e_20250218T19:00_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, my name is [PII] and I was calling because I would like to um.
[CUSTOMER][NEUTRAL] Check benefits
[AGENT][NEUTRAL] OK, I'm so sorry, what was your name? I couldn't understand you at first. It sounded you sounded very far away. [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you and [PII], you said that you're needing eligibility and benefits?
[CUSTOMER][NEUTRAL] Yes
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is the member's policy number?
[CUSTOMER][NEUTRAL] 8002568606
[AGENT][NEUTRAL] That's my phone number. That's not the policy number.
[CUSTOMER][NEUTRAL] Oh, I'm sorry you said they put it all together and I thought it was the number.
[CUSTOMER][NEUTRAL] 02462262 ML 8.
[AGENT][NEUTRAL] Thank you one moment, [PII], while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for me any information that I do provide for you 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] Yes, it's for um [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do show that she is a subscriber on the supplemental policy and the supplemental policy roaming is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information are you needing for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient for a minor X-ray done in an office setting.
[AGENT][NEUTRAL] OK, so her outpatient benefit max per calendar day for covered outpatient services is $1000 and there is no outpatient deductible per cover person per calendar day.
[AGENT][NEUTRAL] Because this is a supplemental policy roaming 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 have processed our claim we do have a portal that you should be able to check claim status and have access to our EOB and our portal website is located at secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, thank you and your first and your last name is?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Any reference call number I always need to ask for one.
[AGENT][NEUTRAL] My name and my name in today's date.
[CUSTOMER][POSITIVE] OK thank you thank you bye bye.
[AGENT][POSITIVE] You're very welcome. And is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] Uh thanks
[AGENT][POSITIVE] OK, well thank you again for calling APL and I hope you have a nice afternoon.