AccountId: 011433970860
ContactId: 38c69650-39d6-4821-ace4-0063f3fcd9e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269850 ms
Total Talk Time (AGENT): 129043 ms
Total Talk Time (CUSTOMER): 39130 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/38c69650-39d6-4821-ace4-0063f3fcd9e4_20250509T12:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. I'm calling to verify benefits for a patient.
[AGENT][NEUTRAL] OK. You do not need eligibility. You only need benefits. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Is it [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, thank you. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 02064066
[AGENT][NEUTRAL] 4066, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] OK, so, uh, any information that's provided today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Ms. [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient hospital.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so she has an outpatient benefit max per occurrence for covered outpatient services of $500.
[AGENT][NEUTRAL] And there is no outpatient deductible.
[CUSTOMER][NEUTRAL] OK, so it's 500 per day.
[AGENT][NEUTRAL] Per occurrence, which means the same or related treatment unless separated by a period of 90 days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Per occurrence and then the effective date?
[AGENT][NEUTRAL] Oh, you also needed it. I'm sorry, I didn't understand. I thought you did not need eligibility. OK.
[AGENT][NEUTRAL] Yes, the supplemental policy is active.
[AGENT][NEUTRAL] And the effective date on this plan is [PII].
[AGENT][NEUTRAL] I'm, I'm sorry. No, ma'am. Let me get back and give you a different date. This policy has an effective date of [PII]. I'm sorry about that.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII].
[AGENT][NEUTRAL] 081. You're welcome. And then just a couple of additional things, [PII], because it is a supplemental policy to the primary insurance, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then once our claim has been processed here at APL we have a portal that you should be able to check claim status in by going to secured. [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and is there a reference number for the call?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[CUSTOMER][POSITIVE] OK, thank you so much Ms. [PII] have a great day.
[AGENT][POSITIVE] Well, I hope you have a great day too, [PII], and if that is all I can help you with, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] OK, bye bye.
[AGENT][NEUTRAL] Bye-bye.