AccountId: 011433970860
ContactId: 513a5391-ca5a-4019-9c82-7cac1301b0a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209860 ms
Total Talk Time (AGENT): 107564 ms
Total Talk Time (CUSTOMER): 41954 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/513a5391-ca5a-4019-9c82-7cac1301b0a8_20250603T17:16_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 [PII], how are you?
[AGENT][POSITIVE] I'm all right. How are you today?
[CUSTOMER][NEUTRAL] I'm good, thank you. My name is [PII]. I'm calling from I'm calling from West Boca Medical Center, and I'm calling to verify, um, benefits for a patient.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so you need to verify benefits only, Rock, so you're not needing eligibility. Is that correct?
[CUSTOMER][NEUTRAL] Um, well, a little both if you don't mind.
[AGENT][POSITIVE] OK, yes, I can help you with both and what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] 02509863.
[AGENT][POSITIVE] All right, thank you, [PII] give me a couple of moments please to get the member's information all pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that Miss [PII] is the spouse of the subscriber on the supplemental policy, and it is active Roxy with an effective date of [PII].
[AGENT][NEUTRAL] And on the supplemental policy, what type of benefit information do you need inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um, inpatient for maternity.
[AGENT][NEUTRAL] So the inpatient benefit maximum per calendar year on this policy is $6000.
[AGENT][NEUTRAL] With no inpatient deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No deductible.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And because it is a supplemental policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When when the claim is submitted to us for review, we will have to have a copy of the primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once the claim has been processed here at APL.
[AGENT][NEUTRAL] We do have a portal in which you all should be able to check her claim status in and that website is located at [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, thank you so much.
[AGENT][POSITIVE] You are certainly welcome. And is there anything else, [PII] that I can help you with?
[CUSTOMER][NEUTRAL] Oh ma'am, that's all.
[AGENT][POSITIVE] OK, well then thank you so much for calling APL and I hope you have a wonderful afternoon.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] Uh-huh, and thank you too. Bye-bye.