AccountId: 011433970860
ContactId: 457e63ba-ac62-44ee-9455-bb3507d468d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184970 ms
Total Talk Time (AGENT): 68669 ms
Total Talk Time (CUSTOMER): 73801 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/457e63ba-ac62-44ee-9455-bb3507d468d3_20250124T17:13_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling. I'm calling from Bas with Outpatient Services. I need to verify members, uh, outpatient benefits.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the outpatient benefits and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 6005.
[CUSTOMER][NEUTRAL] And this is APR and then hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What was your name again? I'm sorry.
[AGENT][NEUTRAL] My name is [PII]. First initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Member ID number is 02336028ML8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh members first, uh, [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And you said outpatient benefits?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] For outpatient, the policy will pay up to $250 per person per calendar day.
[CUSTOMER][NEUTRAL] Alright, so 250 per day.
[CUSTOMER][NEUTRAL] So the remaining amount would be 250, I'm guessing, or like does it accumulate like every.
[AGENT][NEGATIVE] It resets each day.
[CUSTOMER][NEUTRAL] Uh, how would that work? So if a patient is getting an ultrasound done and their copay is $500 you guys only pay $250 because it was done that one day, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We only pay 250 because it's the max and then the next day they'll have another 250 to use.
[CUSTOMER][NEUTRAL] OK, but since it's only be used once because it was done on one day. I'm trying to understand how that works. That's why I was asking.
[AGENT][NEUTRAL] Yes, the max is 250, so we will only apply the 250 to that 500 and then that would exhaust the the the benefits for that data service.
[CUSTOMER][NEUTRAL] OK, so 250 is your name.
[CUSTOMER][NEUTRAL] OK, is there a reference number to this call?
[AGENT][NEUTRAL] No, so there's no call reference number, but you can use my name and today's date.
[AGENT][NEUTRAL] For the reference?
[CUSTOMER][POSITIVE] OK, alrighty then. Thank you so much. Have a good day.
[AGENT][POSITIVE] You're welcome, [PII]. You also, was there anything else I can help with?
[CUSTOMER][POSITIVE] No, that was it. Thank you.
[AGENT][POSITIVE] All right, thanks for calling APL. Have a great weekend. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.