AccountId: 011433970860
ContactId: 714d76dc-b87c-4b9f-9938-86101aaa5b88
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240750 ms
Total Talk Time (AGENT): 132066 ms
Total Talk Time (CUSTOMER): 56388 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/714d76dc-b87c-4b9f-9938-86101aaa5b88_20250116T13:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good morning, [PII]. It's [PII] from [PII]. I need to verify eligibility and outpatient benefits for the patient, please.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] OK, you're needing to verify eligibility and outpatient benefits, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that, but I'm so sorry. What was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and [PII], what is your?
[CUSTOMER][NEUTRAL] Oh, last initial.
[AGENT][NEUTRAL] Oh, OK, thank you. And your call uh excuse me, your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] 02415265.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Uh-huh, you're very welcome.
[AGENT][NEUTRAL] And then the information of the that I'll 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] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do show that she is the spouse of the subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And the outpatient benefit maximum is $400 per covered person per calendar day.
[AGENT][NEUTRAL] For covered outpatient services and there is no outpatient benefit max per calendar day per covered insured.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] So it's 400 per day, correct?
[AGENT][NEUTRAL] Yes, ma'am, that is correct for covered outpatient services.
[CUSTOMER][POSITIVE] Perfect. Any reference number, [PII]?
[AGENT][NEUTRAL] Uh, actually, my name is [PII], and you will use my name, [PII], along with today's date as your call reference number and two additional things that I want to tell you because this is a supplement to the primary insurance, we must have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then also we do have a portal.
[AGENT][NEUTRAL] It is called the um online service excuse me online service center and you can set up a profile to have access to the claim status and EOBs by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, thank you. You said your uh can you spell for me your name? I'm sorry.
[AGENT][NEUTRAL] Do you need, you do need for me to spell it again?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. And last initial?
[AGENT][NEUTRAL] S
[CUSTOMER][POSITIVE] Perfect thank you so much for your help. OK, I'll appreciate.
[AGENT][POSITIVE] OK. Well, you, yes, ma'am. You're very welcome. So if that's all then [PII] that I can help you with today, then thank you again for calling and I hope you have a great day.
[CUSTOMER][NEGATIVE] No thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye bye.