AccountId: 011433970860
ContactId: 612a57bf-d66c-4d08-ae91-d2da6c261289
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245750 ms
Total Talk Time (AGENT): 126198 ms
Total Talk Time (CUSTOMER): 57151 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=2.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/612a57bf-d66c-4d08-ae91-d2da6c261289_20250403T18:31_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, [PII]. My name is [PII]. First initial of my last name is [PII].
[AGENT][NEUTRAL] Mhm. Hi, [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] I'm calling, I'm calling it.
[CUSTOMER][NEUTRAL] Um, yes, I'm calling in regards to a patient who has gap insurance with you guys. I just want to see what the max amount is for outpatient services and if she's met any of that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK [PII], so you're needing benefit information for outpatient and any accumulation, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And what is a good callback number for you?
[CUSTOMER][NEUTRAL] Uh, good call back number [PII].
[AGENT][NEUTRAL] Thank you and the policy number for the number?
[CUSTOMER][NEUTRAL] Yes, let me pull it up. It's going to be
[CUSTOMER][NEUTRAL] 02241482 letters M as in Mary, L as in Lima, and then the number 8.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today 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] Yeah, that's going to be [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on the supplemental policy, [PII]. It is active with an effective date of [PII].
[AGENT][NEUTRAL] And one moment for her outpatient, you did say outpatient benefits correct?
[CUSTOMER][POSITIVE] That is correct. Thank you so much.
[AGENT][NEUTRAL] Welcome.
[AGENT][NEUTRAL] OK, so on this supplemental policy, [PII], she has an outpatient benefit max of $200 per calendar day.
[AGENT][NEUTRAL] For covered outpatient services and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][POSITIVE] OK, perfect. Um, all right, [PII]. Thank you so much. All I would need now is just a reference number.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, and I just wanna give you a couple of additional pieces of information on this, and you may already be aware of this, [PII], but because this is a supplement to the primary, when the claim is submitted to APL, we will have to have a copy of her primary insurance company's explanation of benefits also.
[AGENT][NEUTRAL] For review and then once we've processed our claim here at APL we do have a portal.
[AGENT][NEUTRAL] In which you should be able to check our claim status and that website for it is secured. [PII].
[CUSTOMER][POSITIVE] Thank you so much, [PII].
[AGENT][NEUTRAL] And for you welcome and the reference number would be my name along with today's date and if you need the first initial to my last name, it's [PII].
[CUSTOMER][POSITIVE] All right, thank you so much, [PII]. Have a great day. Enjoy the rest of your week.
[AGENT][POSITIVE] Well, you. Oh, I hope you do too. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, thank you. That was all.
[AGENT][POSITIVE] All right, well thank you for calling APL and I hope you have a great afternoon also.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.