AccountId: 011433970860
ContactId: 4e99c785-7c81-4be1-81f5-de37555db865
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222880 ms
Total Talk Time (AGENT): 104266 ms
Total Talk Time (CUSTOMER): 54115 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/4e99c785-7c81-4be1-81f5-de37555db865_20250507T13:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi. Excuse me. Hi [PII]. This is [PII]. I'm calling from a provider's office to get benefits on a patient, please.
[AGENT][NEUTRAL] OK, and you said your name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], and you're needing to get, do you also need eligibility or only benefits?
[CUSTOMER][NEUTRAL] Uh, just benefits, please.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] 1462925
[AGENT][NEUTRAL] OK, thank you. One moment, [PII] while I get the member's information pulled up please.
[CUSTOMER][POSITIVE] Mm thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, [PII], any information provided 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].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and what type of benefit information do you need on this supplemental policy inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um, it will be outpatient physical therapy.
[CUSTOMER][NEUTRAL] It will be in an office setting.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on the supplemental policy, the outpatient benefit maximum for covered outpatient services is $1000.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar year.
[AGENT][NEUTRAL] Because this is a supplemental policy [PII], to her primary insurance, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] All right. And is there any
[CUSTOMER][NEUTRAL] And um let's see.
[CUSTOMER][NEUTRAL] I think that's it. uh, is there anything applied to that max yet or is it still available?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] As of now, she has not used any of the benefits for this calendar year as of now.
[CUSTOMER][NEUTRAL] OK, OK, great. Alright, [PII], um, do you get that reference numbers?
[AGENT][POSITIVE] Yes ma'am, you will use my name along with today's date.
[CUSTOMER][POSITIVE] All right, thank you so much have a good day.
[AGENT][POSITIVE] OK, well thank you and I appreciate that. I hope you have a great day too, and thank you again for calling APL this morning if that's all I can help you with.
[CUSTOMER][POSITIVE] Thank you. Yes, you've been helpful. Thank you.
[AGENT][POSITIVE] OK. Well, thank you. You're welcome and have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.