AccountId: 011433970860
ContactId: 63a56394-4885-48e5-b8bf-03837b8f5ae9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235369 ms
Total Talk Time (AGENT): 133029 ms
Total Talk Time (CUSTOMER): 54569 ms
Interruptions: 2
Overall Sentiment: AGENT=2.2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/63a56394-4885-48e5-b8bf-03837b8f5ae9_20250606T14:06_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, I think we just spoke. [PII] is [PII].
[AGENT][NEUTRAL] Oh hi [PII]. Yes, ma'am, we sure did. Do you have another member you're needing to check eligibility benefits on.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yes, I do. I have a new member that needs benefit as well.
[AGENT][POSITIVE] OK, sure. And if you'll just give me, OK, if you'll give me your callback number, please, yes, I can help you with that.
[CUSTOMER][NEUTRAL] Of course, it's gonna be.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 267963 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And the same will apply any information provided would be a verification of benefits and not a guarantee of payment. What is the patient's name this time and their date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the date of birth, give me one moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII] is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so on this member, uh, yes, ma'am, she is a cover dependent under this policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Of visit and outpatient surgery, please.
[AGENT][NEUTRAL] OK, so the office visit is also not covered under this policy?
[AGENT][NEUTRAL] And the outpatient benefit max per calendar year for covered outpatient services is $1500 and there is no outpatient deductible per covered person per calendar year.
[AGENT][POSITIVE] And if you'll give me a moment, I can check her accumulations for you as well.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEGATIVE] And as of now, she has not used any of her benefits.
[AGENT][NEUTRAL] For this calendar year, for this calendar year. I cannot even say it for this calendar year.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] We just calendar year.
[AGENT][POSITIVE] Oh, wow. And then same thing, I, I know, and it has been an extremely long week. I'm certainly glad to see Friday roll around, but, um, and the same with this one. This is one that we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim.
[CUSTOMER][NEUTRAL] It's OK, it's Friday and.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then the same would be for the portal for checking claim status at [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. You have a great day and a great weekend.
[AGENT][POSITIVE] All right. Well, you're welcome. Uh yes, ma'am, you too. I'll probably be talking to you again today, it seems like, and that'll be just fine.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, [PII]. Well then, thank you.
[CUSTOMER][POSITIVE] You have a great beautiful day, OK?
[AGENT][POSITIVE] Yes, ma'am. You too. And it was my pleasure in speaking to you again. So thank you for calling APL.
[CUSTOMER][NEUTRAL] OK.