AccountId: 011433970860
ContactId: 4f2e1f46-f9f7-4d63-afe4-4a25cf6bed52
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275149 ms
Total Talk Time (AGENT): 123475 ms
Total Talk Time (CUSTOMER): 83791 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/4f2e1f46-f9f7-4d63-afe4-4a25cf6bed52_20250522T17:57_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling from provider's office, um, to check to see if this plan covers for specialist office visits.
[AGENT][NEUTRAL] OK, [PII], you, you're needing benefit information for a specialist office visit, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and your number uh patient's policy number, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second, sorry, uh, my group number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, the member's policy number.
[CUSTOMER][NEUTRAL] Mm, let's see here one second. There's an in-hospital cert number or
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] One for all patients, sir.
[AGENT][NEUTRAL] OK, you may give me either one.
[CUSTOMER][NEUTRAL] OK. Um 0160.
[CUSTOMER][NEUTRAL] 2288 ML 8.
[AGENT][NEUTRAL] OK, thank you, one moment please.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I have here um [PII]. Date of birth [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And again, any information, [PII] that I do provide the verification of benefits and not a guarantee of payment. I do show that he is the subscriber on the supplemental policy.
[CUSTOMER][NEUTRAL] There you go.
[AGENT][NEUTRAL] And this policy is active with an effective date of [PII].
[AGENT][NEGATIVE] And this supplemental policy does not have benefits for an office visit.
[AGENT][NEGATIVE] Office visits are not covered.
[CUSTOMER][NEUTRAL] OK, so it's only for a hospital.
[CUSTOMER][NEUTRAL] For hospital inpatient and outpatient facilities?
[AGENT][NEUTRAL] Yes, R for
[AGENT][NEUTRAL] Outpatient facilities, diagnostic testing facility, urgent care.
[AGENT][NEUTRAL] Hospital emergency room.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But not an, not treatment within the office or an office visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now in the future though?
[CUSTOMER][NEUTRAL] Alright, so when you're through, that's all I needed to, yeah, go ahead.
[AGENT][NEUTRAL] Oh, I'm sorry, I was gonna go ahead and just give you a website that we have that you should be able to check claim status in for our members once we've processed the claim. The portal website for us is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, so I'll try to, um, so I can just Google it and try to get access through there.
[CUSTOMER][NEUTRAL] The portal.
[AGENT][NEUTRAL] You would just type up, type in that website [PII]. Yes ma'am, and then you would follow the steps to register.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that would be for claims status.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] Alright, when you threw all of the time.
[CUSTOMER][NEUTRAL] No, just the reference number for the call please.
[AGENT][POSITIVE] Yes ma'am, you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK, sorry, I refresh the name please.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty thank you very much.
[AGENT][POSITIVE] OK. Well, you're certainly very welcome. And again, thank you for calling APL. I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] You too thanks bye.
[AGENT][POSITIVE] Yes ma'am. Thank you, bye bye.
[CUSTOMER][NEUTRAL] OK