AccountId: 011433970860
ContactId: 3b13bebc-b9e2-4d1d-8f64-dad224916f84
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194779 ms
Total Talk Time (AGENT): 113110 ms
Total Talk Time (CUSTOMER): 39556 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/3b13bebc-b9e2-4d1d-8f64-dad224916f84_20250116T18:56_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, good afternoon. I'm calling to check benefits for a patient, please.
[AGENT][NEUTRAL] OK, so do you only need benefits or do you also need eligibility?
[CUSTOMER][NEUTRAL] Uh yeah, benefits and eligibility.
[AGENT][NEUTRAL] OK. Yes, ma'am, I can help you with those things. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Uh yeah, I have 02580221 ML.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] Uh, his name is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on the supplemental policy.
[AGENT][NEUTRAL] Supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefit information are you needing on the supplemental plan inpatient, outpatient or office? OK.
[CUSTOMER][NEUTRAL] Or physical therapy?
[CUSTOMER][NEUTRAL] Outpatient physical therapy.
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEUTRAL] OK, so he has an outpatient benefit max of $500 per covered person per calendar day for covered outpatient services with no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And because this is a supplemental plan, [PII], when the claim is submitted to APL for review, we must also have a copy of this primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] And then once we have processed our claim we do have a portal that you can check claim status and access the EOB for APL and our portal website is at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can I get a reference number for the call?
[AGENT][NEUTRAL] OK, you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right. You are certainly very welcome. So if that's all I can help you with, and thank you again for calling APL Angel and I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] You too. Take care. Bye-bye.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Right