AccountId: 011433970860
ContactId: 410032e6-5529-492d-bc34-e8f077290592
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232399 ms
Total Talk Time (AGENT): 138702 ms
Total Talk Time (CUSTOMER): 70509 ms
Interruptions: 4
Overall Sentiment: AGENT=1.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/410032e6-5529-492d-bc34-e8f077290592_20250425T14:15_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] the Bluetooth devices right in there.
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] The Bluetooth device
[CUSTOMER][NEUTRAL] Yes, I'm needing to verify benefits on a patient.
[AGENT][NEUTRAL] OK, you're only needing benefits. You do not need eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can help you with benefits, and who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [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, [PII]?
[CUSTOMER][NEUTRAL] It is 02506280.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will 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.
[CUSTOMER][POSITIVE] Good
[AGENT][NEUTRAL] OK, so on the supplemental policy, what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Office?
[AGENT][NEUTRAL] Cases for an office visit or treatment within the office?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Office visit, or can I get both?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on the supplemental policy, office visits are not covered?
[AGENT][NEUTRAL] If she receives some form of treatment in the office, that can be reviewed under her outpatient benefits and her outpatient benefit max per calendar year for covered outpatient services is going to be $7500.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] How are you?
[CUSTOMER][NEUTRAL] And [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there is no outpatient deductible per cover person per calendar year.
[AGENT][NEUTRAL] Now, [PII], because this is a supplement to her primary insurance, if you all do file a claim with us for her, we will also have to have a copy of her primary insurance company's explanation of benefits.
[CUSTOMER][POSITIVE] Alright, thank you very much you have a wonderful day today and it's Friday.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That shows the amounts applied to her co-pay deductible or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we've processed our claim, we do have a portal that you should be able to check our claim status in.
[CUSTOMER][NEUTRAL] like
[AGENT][NEUTRAL] And that portal website is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then that 7500 has she used anything towards that?
[AGENT][NEUTRAL] OK, and you are referring for a data service for this calendar year?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Uh, no, ma'am. As of now, no benefits have been used.
[CUSTOMER][NEUTRAL] OK, and that's only it applies to that if she gets treatment within the office for that day, OK.
[AGENT][NEUTRAL] Yes ma'am, the office visit, right, the office visit itself is not a covered service.
[CUSTOMER][NEUTRAL] With the office.
[CUSTOMER][NEUTRAL] So just the treatment.
[AGENT][NEUTRAL] Mhm, could be reviewed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] All right, well thank you and may I have a reference number as well?
[AGENT][POSITIVE] All right. Well, you're welcome and is there.
[AGENT][NEUTRAL] Yes, ma'am. You would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK, what was your name again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII], alright, well thank you [PII].
[AGENT][POSITIVE] Yes, ma'am. Well, you're welcome. And again, is there anything else I can help you with?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] OK, well then, thank you so much for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Alright thank you you as well.
[AGENT][POSITIVE] All right. Thank you so much.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.