AccountId: 011433970860
ContactId: 3e7af1c4-d70f-46af-af3f-25b5299c0bee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227860 ms
Total Talk Time (AGENT): 83708 ms
Total Talk Time (CUSTOMER): 87261 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/3e7af1c4-d70f-46af-af3f-25b5299c0bee_20250527T14:59_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from a provider's office in regards to some eligibility and uh benefits.
[AGENT][POSITIVE] OK, well, I can definitely help you with the eligibility and benefits. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII] um policy number 2609826.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that, and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII]. And did you need a copy of the um fax back or did you have particular questions?
[CUSTOMER][NEUTRAL] I do have particular questions. I actually just called to receive the fax back from you guys, and it is, um, it is, um, printing out as we speak. Um, I have, yeah, 2 out of I think like 4 pages. So basically, um, earlier when I called I was provided a different number to call to find out for the network status, and I called that number and they're not able to pull up the part policy um so.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I was calling back to see if maybe yes if you can assist me with just a few questions about her policy wanted to see if there was um what her annual maximum is left.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] My apologies, our systems are moving slow. So, um,
[AGENT][NEUTRAL] So the calendar year max is $500. There's a $50 deductible, and for [PII], she's used all $500 and met the deductible.
[CUSTOMER][NEUTRAL] She's used all 500 and meta deductible.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's OK, so no no more benefits left for this year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Got you. OK, um, and one more question, when I, when I bill, and I, are you guys accepting, um, um, online claims?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, we accept online claims that will use the payer ID. Well, I'm sorry.
[AGENT][NEUTRAL] That's for electronic payments, but online like through our portal, no, um, but electronic, yes, with the payer ID.
[CUSTOMER][NEUTRAL] Electronic, yeah.
[CUSTOMER][NEUTRAL] Got you. OK, and I did notice here on the back of the card that I have to put like, uh, do I have to register um as a new, um, provider if I wanted to check online.
[AGENT][NEUTRAL] Once the
[CUSTOMER][NEUTRAL] Through APL?
[AGENT][NEUTRAL] Right, once the claim has been submitted and um you receive the explanation of benefits, you, if you don't have a uh online profile with us as a provider, yes, you'll have to sign up as a new user.
[CUSTOMER][POSITIVE] OK, OK, OK, perfect, thank you so much that was all the information that I needed.
[AGENT][POSITIVE] Alrighty [PII]. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye bye.