AccountId: 011433970860
ContactId: 42622258-0be4-4a2a-be6f-cc268092d8b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228119 ms
Total Talk Time (AGENT): 117632 ms
Total Talk Time (CUSTOMER): 44900 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/42622258-0be4-4a2a-be6f-cc268092d8b2_20250417T20:15_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling to verify benefits for a member.
[AGENT][NEUTRAL] OK, [PII], do you just need benefits or do you also need eligibility?
[CUSTOMER][NEUTRAL] Uh, just the benefits if they got the benefits and they should be eligible, right?
[AGENT][POSITIVE] OK, I can provide that information for you. And what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] Thank you and the member's policy number please?
[CUSTOMER][NEUTRAL] 01622841
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you one moment please while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information [PII] that I do provide would be a verification to guarantee your payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um, this is for a sleep study done at the home with the code G0399, so I guess outpatient.
[AGENT][NEUTRAL] OK, so he has an outpatient benefit maximum of $500 per calendar day.
[AGENT][NEUTRAL] For covered outpatient services and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK, $500 per day.
[AGENT][NEUTRAL] Because, and, yes, ma'am, and [PII] because this is a supplemental policy.
[AGENT][NEUTRAL] C2 is primary insurance when the claim is filed with us, we'll still have to have a copy. Can you hear me?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah, your phone's going out.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] I'm not sure if it's, I can hear you now. Yes, ma'am.
[AGENT][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] I can hear you now mhm.
[AGENT][NEUTRAL] I was saying is because this is a supplemental policy to his primary insurance when the claim is submitted to APL for review, we must also receive a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we process our claim here we do have a portal that you should be able to check our claim status in and the website for that is located at [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright [PII] thank you and is there a reference number for the call?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[CUSTOMER][POSITIVE] All right, well that's all I needed thank you so much for your help and you have a great day.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Well, absolutely. You're very welcome. So again, if that's all I can help you with, thank you for calling APL and I hope you have a great.
[CUSTOMER][POSITIVE] Thank you goodbye.
[AGENT][POSITIVE] Good afternoon as well.
[AGENT][NEUTRAL] Yes, ma'am. Bye bye.