AccountId: 011433970860
ContactId: 5019c3e7-1e36-45f1-a006-8fee18beb086
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284799 ms
Total Talk Time (AGENT): 120875 ms
Total Talk Time (CUSTOMER): 129191 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/5019c3e7-1e36-45f1-a006-8fee18beb086_20250220T22:25_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Thank you calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] So, I need to verify, I need to verify benefits and eligibility on this patient.
[CUSTOMER][NEUTRAL] I'm calling from the provider's office.
[AGENT][POSITIVE] OK, I can help you with.
[AGENT][NEUTRAL] Yes sir, I can help you with benefits and eligibility. Can I please get your name, your number, and the providers office name that you're calling for?
[CUSTOMER][NEUTRAL] First I missed your name. Is that [PII]? How do you spell it?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And initial to your last.
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] My name is [PII], administrator rea for the group. My callback number is [PII].
[AGENT][NEUTRAL] Thank you sir and now what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] I have [PII] date of birth [PII].
[CUSTOMER][NEUTRAL] And she gave us 02506058 as the member ID.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] OK, I do show that Nebraska does have an active policy with us and her effective date is [PII].
[CUSTOMER][NEUTRAL] It's what?
[AGENT][NEUTRAL] And this is just to verify 61 of 20.
[CUSTOMER][NEUTRAL] You're getting
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 61 of 2024.
[AGENT][NEUTRAL] And this is to verify benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She has a supplemental insurance policy that's billed secondary to the primary. It helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] She has an inpatient benefit amount of yes.
[CUSTOMER][NEGATIVE] And it's active no.
[CUSTOMER][NEUTRAL] How much? For no outpatient for the office. This is for office visits.
[AGENT][NEUTRAL] OK, let me see if she has office visits on this plan.
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][NEUTRAL] Office visits, office ultrasounds. I just need to check it.
[AGENT][POSITIVE] Oh, she does have um treatment in an office. She has a $500 benefit for office.
[CUSTOMER][NEUTRAL] OK, so she has up to 500, OK.
[CUSTOMER][NEUTRAL] And can I have a reference for our call please?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] I'm sorry, I
[AGENT][NEUTRAL] I'm going to correct myself.
[AGENT][NEUTRAL] It's $5000 per calendar year for outpatient. I apologize. I was 10 off.
[CUSTOMER][NEUTRAL] And that will, that will.
[CUSTOMER][NEUTRAL] Got it. I figured, but it's OK. So for the office for office that will be outpatient, OK, and the ID number is correct?
[AGENT][NEUTRAL] Yes, the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Perfect and we submit the claims of [PII].
[AGENT][POSITIVE] Yes, that, that's right.
[CUSTOMER][NEUTRAL] A very cold state right now.
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] Did you see the fountain in [PII] that was showing it on the Weather Channel. It was crazy, freezing below 0.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm gonna have to look and see.
[AGENT][NEUTRAL] Yeah, it's cold. I live in
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][NEGATIVE] No, I don't like it either. I actually live in [PII] and it is.
[CUSTOMER][NEUTRAL] Oh, you're south and you're still, yeah, in [PII] it's just in the [PII]. I'm sorry.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, today here, the low is 19 degrees for [PII].
[CUSTOMER][NEUTRAL] Mm, oh yeah, it's too cold.
[AGENT][NEUTRAL] And then we're not gonna get above freezing today.
[CUSTOMER][NEGATIVE] Poor swamp people there I'm telling you it's not easy.
[AGENT][NEGATIVE] I know, right? Kill all the alligators and mosquitoes, please.
[CUSTOMER][POSITIVE] All right, that can I have a reference when you get a chance? thank you.
[AGENT][NEUTRAL] Yes, you can use my name, [PII], and today's date.
[CUSTOMER][NEUTRAL] Because she's
[CUSTOMER][POSITIVE] [PII] alrighty thank you have a wonderful evening.
[AGENT][POSITIVE] You're welcome you too bye bye, sir.
[CUSTOMER][POSITIVE] Thank thank you bye bye.
[AGENT][POSITIVE] Thanks for calling
[CUSTOMER][NEUTRAL] Uh huh.