AccountId: 011433970860
ContactId: 5c7f4c3e-c60f-4c38-a704-62c0a5e798e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166009 ms
Total Talk Time (AGENT): 86536 ms
Total Talk Time (CUSTOMER): 53277 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/5c7f4c3e-c60f-4c38-a704-62c0a5e798e6_20250131T14:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I need to verify eligibility and benefits for a patient please.
[AGENT][NEUTRAL] OK, I can help you with both the eligibility and the benefits. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII]
[CUSTOMER][NEUTRAL] Phone number [PII].
[AGENT][NEUTRAL] Thank you for that. And the member's policy number?
[CUSTOMER][NEUTRAL] Um, I have 60801.
[AGENT][NEUTRAL] Oh, that's our payer ID. Um, on the card, do you see, it might say member ID or it may say in hospitals or outpatient policy certification number?
[CUSTOMER][NEUTRAL] Um, I have 00613608.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII]. And um did you need a copy of the fax back or you have particular questions about it?
[CUSTOMER][NEUTRAL] Um, if you can do a fax like that would be helpful.
[AGENT][NEUTRAL] Oh, sure. So on the fax back you'll see the calendar year max, deductible, all the frequencies, limitations, all the ways to file a claim, and then there's a list of codes and the benefit amount that the policy um could pay for um for that particular code.
[CUSTOMER][NEUTRAL] OK, um, on this policy is there out of network benefits?
[AGENT][NEUTRAL] Um, this policy isn't on the network.
[AGENT][NEUTRAL] It's just
[CUSTOMER][NEUTRAL] OK, is this.
[CUSTOMER][NEUTRAL] Is it a supplement like to another policy?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] No, um, this is, no, it's not second to anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's, um, [PII], what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And should I put attention [PII]?
[CUSTOMER][POSITIVE] You can, yes ma'am.
[AGENT][NEUTRAL] Just to make sure I have it right, it's [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, so I'm faxing this over to you now. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, I think that'll be all.
[AGENT][POSITIVE] Alrighty, well, thank you so much for calling [PII]. I hope you have a great weekend.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] You're welcome bye bye.
[CUSTOMER][NEUTRAL] Bye bye.