AccountId: 011433970860
ContactId: 4356fe32-3326-419a-87e7-77b4c028e4ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266609 ms
Total Talk Time (AGENT): 124690 ms
Total Talk Time (CUSTOMER): 87166 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/4356fe32-3326-419a-87e7-77b4c028e4ae_20250514T13:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. My name is [PII]. I'm calling for Texas Digestive specialist. I'm calling because I want to know benefit and eligibility for a member, please.
[AGENT][NEUTRAL] OK, did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], I'm so sorry. OK, [PII], and you're needing benefits and eligibility. Is that correct for a member?
[CUSTOMER][NEUTRAL] Yes, that's OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with those things, and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 01868788
[AGENT][NEUTRAL] OK, thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And any information [PII] that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Good morning
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so like any information again that this provided today will be a verification of benefits and not a guarantee of payment. I do show that she is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] You tell me the date effective as [PII]?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK perfect and expiry uh expiry date is uh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There is not one. I said the policy is active. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. OK so is um you told me this, this plan is sup supplemental?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, uh, under one plan, uh.
[AGENT][NEUTRAL] This is a supplemental policy to her primary health care insurance.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] OK, I don't know if the patient has um uh office visits copay.
[AGENT][NEUTRAL] OK, so on this plan office visits are not covered.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, let me check, uh, that's it, [PII], can you please give me your reference number for the call?
[AGENT][NEUTRAL] OK, and that's all of the benefit information you needed is just you know if an office says it was covered, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, OK. So you're saying the reference number will be my name and today's date.
[AGENT][NEUTRAL] And just if you can make a note in the future, [PII] for members who have this type of policy, once we have processed a claim here at APL, we do have a portal that you can check claim status in, and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And is there
[AGENT][POSITIVE] No, ma'am. It is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect, so thank you so much, [PII] have a good day.
[AGENT][POSITIVE] OK, well I hope you have a good day too, and if that is all I can help you with [PII] and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you.