AccountId: 011433970860
ContactId: 404da1fc-b335-4338-a3ee-073eae0f7770
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273630 ms
Total Talk Time (AGENT): 105980 ms
Total Talk Time (CUSTOMER): 93268 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/404da1fc-b335-4338-a3ee-073eae0f7770_20250613T15:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Um, yes, I was calling to verify, uh, patients, um, benefits please and eligibility.
[AGENT][NEUTRAL] OK. Yes, ma'am. I can verify benefits and eligibility for you. And your name is?
[CUSTOMER][NEUTRAL] [PII], and what was yours?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Sure, it is 02611488.
[AGENT][NEUTRAL] OK, thank you, ma'am. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Um, name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, I'm showing her effective date is [PII]. She is active on the policy and what benefits are needed for this patient?
[CUSTOMER][NEUTRAL] Um, the CPT code is 25448.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um the diagnostic code is M [PII].
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] And is this gonna be in an outpatient facility?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, not a guarantee of payment, just a verification of coverage. With this policy, we are secondary. We help with primary insurance, deductible, co-pay, and or co-insurance, and the patient has a benefit max up to $6500 per calendar year.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I don't show she's used any of her benefits, so it is available.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So there's like no there's no deductible copay, nothing like that it's just $6500 per calendar year.
[AGENT][NEUTRAL] Uh, yes, ma'am. Of what her primary applies towards deductible co-pay or co-insurance for outpatients.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Is there a mailing address for claims?
[AGENT][NEUTRAL] Uh, yes, ma'am. It's [PII].
[CUSTOMER][NEUTRAL] Hold on one second, I'm just trying to, OK.
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] [PII], go ahead.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, and payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801 and is there a group number for this policy?
[AGENT][NEUTRAL] Uh yes ma'am, give me one moment.
[AGENT][NEUTRAL] Group number 27031.
[CUSTOMER][NEUTRAL] 27031.
[AGENT][NEUTRAL] 31. Yes, ma'am.
[CUSTOMER][NEUTRAL] 27031 OK um.
[CUSTOMER][NEUTRAL] Group ID pair ID.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm just writing this down sorry.
[AGENT][NEUTRAL] No, no, you're fine.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I think I, yeah, so it's only 6500 per calendar year.
[CUSTOMER][NEUTRAL] OK, I just need a reference number for this call please.
[AGENT][NEUTRAL] Uh, you can use my name in today's date.
[CUSTOMER][NEUTRAL] So it would be [PII].
[AGENT][NEUTRAL] Sure, yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Uh, yes ma'am, thank you for calling APL. Have a great day and weekend.
[CUSTOMER][NEUTRAL] You too.