AccountId: 011433970860
ContactId: 69e8fa40-fa2f-401f-9e8c-52d47a73f706
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 255039 ms
Total Talk Time (AGENT): 104826 ms
Total Talk Time (CUSTOMER): 73502 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/69e8fa40-fa2f-401f-9e8c-52d47a73f706_20250623T21:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL my name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling because I'm needing to verify benefits for patients.
[AGENT][NEUTRAL] OK, I can help with that. May I have your name?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII]
[AGENT][POSITIVE] Thank you so much and and what is your callback number if we are disconnected please?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][POSITIVE] Thank you so much. And what is the policy number, please?
[CUSTOMER][NEUTRAL] It is going to be um so I have two different ID numbers so I'm not sure which one she currently has, uh, I have here.
[CUSTOMER][NEUTRAL] We give you what's on the card that we have um I have for inpatient and outpatient. I have 021 8.
[CUSTOMER][NEUTRAL] 5090, M as in Mary, L as in Larry, the number 8.
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] I have that as 02185090 ML 8.
[AGENT][NEUTRAL] The policy number.
[AGENT][NEUTRAL] And verify the patients.
[CUSTOMER][NEUTRAL] 5090. There's a, I'm sorry, there's a 0 after the 9.
[AGENT][POSITIVE] Yes, yes, I do.
[CUSTOMER][NEUTRAL] You have that?
[CUSTOMER][NEUTRAL] OK. Uh, the patient's name is gonna be [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] OK, and that policy shows its termed as of [PII].
[AGENT][NEUTRAL] Let me check to see if there's an active policy or do you have another policy number to provide to me?
[CUSTOMER][NEUTRAL] I do. I have 02337106.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][POSITIVE] OK, thank you so much. I show that plan effective as of [PII] and it shows active as a secondary. Would you need benefits for as well?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK. Please note verification of benefits provided does not guarantee payment. For outpatient, we will pay up to $1000 for the calendar year.
[CUSTOMER][NEUTRAL] OK, and has any of the amount been used and that would be January through December?
[AGENT][NEUTRAL] That is correct. And currently nothing has been used for this year.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and the benefits for inpatient, are they the same?
[AGENT][NEUTRAL] Let me check that for you one moment.
[AGENT][NEUTRAL] OK, one moment actually she has used her outpatient, um, one second to get that accumulation for you.
[AGENT][NEUTRAL] Currently she has used $70 that's 70 has been used now for the inpatient, let me check that for you.
[AGENT][NEUTRAL] For inpatient, we will pay up to $4000 for the calendar year and that's for inpatient, and she has not used any of her inpatient benefits for this year.
[CUSTOMER][NEUTRAL] OK, and this is gonna be for inpatient.
[CUSTOMER][NEUTRAL] OK, and then may I please have a reference number for today's call?
[AGENT][NEUTRAL] We do not use reference numbers, but you can use my name [PII] last initials [PII] and today's date. Would you need any information as far as claim submission?
[CUSTOMER][POSITIVE] No, that would be all thank you I really appreciate it.
[AGENT][POSITIVE] You're welcome and thank you so much for calling APL. Have a great week thank you.
[CUSTOMER][POSITIVE] Have a great day bye bye.
[AGENT][NEUTRAL] You too.