AccountId: 011433970860
ContactId: 4a76c492-b5b5-4c11-9159-0f4302f5eac4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202639 ms
Total Talk Time (AGENT): 76177 ms
Total Talk Time (CUSTOMER): 50206 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/4a76c492-b5b5-4c11-9159-0f4302f5eac4_20250602T16:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um yes, I'm calling uh from a provider's office trying to get some benefit information for a member.
[AGENT][POSITIVE] I can help you with benefit information. Can I get your name and a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh yes, my name is [PII] and call back is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Um, let's see here.
[CUSTOMER][NEUTRAL] I've got 02478737 ML and then the number 8.
[AGENT][NEUTRAL] OK, one moment while I look that up for you.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me please?
[CUSTOMER][NEUTRAL] Um, Avi [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] I'm showing that this policy is active an effective date of [PII].
[AGENT][NEUTRAL] Um, were there specific benefits you were wanting to know about inpatient or outpatient?
[CUSTOMER][NEUTRAL] I it's outpatient diagnostic labs.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull that up.
[AGENT][NEUTRAL] This is just a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] This is
[AGENT][NEUTRAL] It looks like there is an outpatient benefit maximum of up to $300 per calendar day with a $0 outpatient deductible per calendar day. Uh, same with emergency room. It looks like we do allow diagnostic testing within a hospital. It is subject to a maximum of 30 days of treatment per covered person per calendar year.
[CUSTOMER][NEUTRAL] So you say up to $300 a day, that is you all will pay up to $300 per day.
[AGENT][NEUTRAL] Yes, and this is secondary gap insurance, so we will need the primary EOB within the claim, uh showing that some or partial benefits were paid by the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] And can I get a reference number for the call please?
[AGENT][NEUTRAL] We don't have reference numbers, but you can use my name and last initial in today's date, so [PII] and today's date.
[CUSTOMER][POSITIVE] All right I appreciate it so much.
[AGENT][POSITIVE] Great, thank you for calling APL. If there's nothing else, I hope you have a great day.
[CUSTOMER][POSITIVE] You as well thank you.