AccountId: 011433970860
ContactId: 40a06e49-0bbd-4921-a462-e5e18fb28aad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221520 ms
Total Talk Time (AGENT): 129498 ms
Total Talk Time (CUSTOMER): 56010 ms
Interruptions: 1
Overall Sentiment: AGENT=2.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/40a06e49-0bbd-4921-a462-e5e18fb28aad_20250121T19:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], I um, good afternoon, it's [PII] from [PII]. How are you?
[AGENT][NEUTRAL] I'm good, [PII]. How are you?
[CUSTOMER][NEUTRAL] Good, good. Uh, I need to verify eligibility. I need to verify eligibility and benefits for the patient, please.
[AGENT][POSITIVE] Good. Well, how can I help you today?
[AGENT][NEUTRAL] OK, so you need eligibility and benefit benefit information, [PII]? Yes, ma'am, I can help you with both of those things. And what is your callback number please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] 01666110.
[AGENT][POSITIVE] Thank you one moment please.
[AGENT][NEUTRAL] And any information affiliated that I do provide for you today 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] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the spouse of the subscriber on the supplemental policy, and the supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And are you needing inpatient, outpatient or office benefits for him?
[CUSTOMER][NEUTRAL] Outpatient, outpatient benefit.
[AGENT][NEUTRAL] OK, so he has an outpatient benefit max.
[AGENT][NEUTRAL] For covered, uh, excuse me, an outpatient benefit maximum of $500.
[AGENT][NEUTRAL] Per calendar day per covered person for covered outpatient services, with no outpatient deductible for covered person per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And I'm sure that you're already familiar with the, the last two things, but when the claims are submitted to APO for this policy, we will have to have a copy of the primary insurance company's explanation of benefits as well, and then we do have our portal for to check claim status and that website is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, thank you, uh, [PII]. Um, any reference number?
[AGENT][NEUTRAL] Yes, use my name along with today's date and I spell [PII] And is yours, your first name, does it have a [PII] or is it with an [PII]? I can't remember.
[CUSTOMER][NEGATIVE] [PII].
[AGENT][NEUTRAL] [PII], is it?
[CUSTOMER][NEUTRAL] Oh yeah, yes, correct. And what is your last initial [PII]?
[AGENT][NEUTRAL] S [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, thank you so much for your help. OK, I'll appreciate it.
[AGENT][POSITIVE] Or yours. Yes, ma'am. You are certainly very welcome. So is there anything else that I can help you with?
[CUSTOMER][POSITIVE] Oh thank you, very nice. I'll appreciate it.
[AGENT][POSITIVE] OK, well, thank you for calling APL then and I hope you have a wonderful afternoon.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.