AccountId: 011433970860
ContactId: 6ebbc65f-da6f-4cfa-a90c-5b8102d6ea04
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247440 ms
Total Talk Time (AGENT): 120219 ms
Total Talk Time (CUSTOMER): 55598 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/6ebbc65f-da6f-4cfa-a90c-5b8102d6ea04_20250311T20:32_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. I was calling to verify um eligibility for a patient.
[AGENT][NEUTRAL] OK, you're only needing eligibility. You do not need benefit information, is that correct?
[CUSTOMER][POSITIVE] Yes, I can, I can use the benefits also.
[AGENT][NEUTRAL] Yes, mama.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that and who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and may I see what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] It is 02474380, M as in Mary, L as in Lima, the number 8.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Uh patient's name is [PII] is the first name. Last name is [PII] [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now the policy, she is a subscriber, however, the policy number that you gave me is an old policy number, that policy actually turns [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There's a different policy number that is active and that number is 0247.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 4382.
[CUSTOMER][NEUTRAL] 82.
[AGENT][NEUTRAL] And uh-huh, and that policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And one moment while I get that information pulled up please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And may see what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the outpatient benefit maximum per calendar year for covered outpatient services is $8500 with no deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if you
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] If you all file a claim with us for her on this policy, [PII], we will also have to have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal that you should be able to check claim status in by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. And is there anything else that I can help you with this afternoon?
[CUSTOMER][NEUTRAL] No, I'm sorry. I just need the initial of your last name if, if possible, and a reference number for the call.
[AGENT][NEUTRAL] My name and today's date will be your call reference number and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Well, you are very welcome. So again, thank you for calling APL and I hope you have a very nice evening.
[CUSTOMER][NEUTRAL] Likewise, bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.