AccountId: 011433970860
ContactId: 46da175c-7ed6-4352-9197-a1f1b94d9e49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180000 ms
Total Talk Time (AGENT): 107443 ms
Total Talk Time (CUSTOMER): 58113 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/46da175c-7ed6-4352-9197-a1f1b94d9e49_20250115T21:43_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII] at Family Focused care. Um, I was actually calling to see, are we in network with you guys?
[AGENT][NEUTRAL] OK, Mammy, so you're trying to find out if your provider is in network. Is that correct? Yes, ma'am, I can help you with that. Uh, what is a good callback number for you first off?
[CUSTOMER][NEUTRAL] Yes, ma'am. Yes ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, Mammy?
[CUSTOMER][NEUTRAL] Um, the policy number is 02583068.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah, it says you're gonna have to work all that and I said, can you reschedule, but they said you need to pay because you're needing.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK, [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 date of birth?
[CUSTOMER][NEUTRAL] She said
[CUSTOMER][NEUTRAL] Um, her name is [PII]. Her date of birth is, um, [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] We can't do
[AGENT][NEUTRAL] OK, so she is the spouse of the subscriber on this supplemental policy, [PII]. Now because this is a supplement to the primary insurance, there is not a network with our company.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] This would follow her primary.
[AGENT][NEUTRAL] And when if you all submit a claim to APL for our review, we will also have to have a copy of her primary insurance company's explanation of benefits along with that claim.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] But this supplemental policy is active, effective [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so it's no in network out of network with you guys?
[AGENT][NEUTRAL] No, ma'am. There is no network affiliated with APL.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, yeah, she, she wasn't very sure she was like, I don't know if they'll cover it, but I just called to make sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Absolutely, but yes, and there's gonna work with this. And again, if you do submit a claim with to uh, uh, let me try, let me start that one over. [PII], if you all do file a claim with APL, just make sure to include the primary insurance's explanation of benefits as well. And then we do have a portal that you can set up a profile to check our claim status, and that portal is secured.
[CUSTOMER][NEGATIVE] I need you back.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I got it pulled up thank you so much.
[AGENT][POSITIVE] Well, you are very welcome. And is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No ma'am, that's all.
[AGENT][POSITIVE] Well then, thank you very much for calling APL and I hope you have a nice evening.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] All right, thank you. Bye-bye.