AccountId: 011433970860
ContactId: 6ac86632-180d-4910-a4a1-71d59222035c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154660 ms
Total Talk Time (AGENT): 97895 ms
Total Talk Time (CUSTOMER): 37249 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/6ac86632-180d-4910-a4a1-71d59222035c_20250102T18:48_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]. I was calling to get outpatient benefits for patients that's coming in.
[AGENT][NEUTRAL] OK, well you're needing outpatient benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] is that correct? Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] It is 01813208.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Do you also need eligibility or only benefit information?
[CUSTOMER][NEUTRAL] Um, both, I would have to check if it's active.
[AGENT][NEUTRAL] So she is the spouse of the insured and this supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And on the outpatient benefit, the maximum is $500 per covered person per calendar day for covered outpatient services, and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] if you can make a note that when the claim is submitted to APL, we must also receive a copy of her primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then claim status can be checked once we've processed our claim in our portal at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Alright, [PII], those were the only questions I had. Thank you so much for your help, OK.
[AGENT][NEUTRAL] OK. Oh. You're very welcome. And if you need a reference number for our call today, just use my name along with today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you again. Have a good afternoon.
[AGENT][POSITIVE] OK, well, you too, [PII], and um thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][NEUTRAL] Bye-bye.