AccountId: 011433970860
ContactId: 7cbdee91-dbc3-4cdf-bc8a-9e510b351c35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225320 ms
Total Talk Time (AGENT): 98673 ms
Total Talk Time (CUSTOMER): 100645 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/7cbdee91-dbc3-4cdf-bc8a-9e510b351c35_20250625T20:12_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, hello, um, I, I just need to check uh benefits and eligibility, ma'am, for one of our patients.
[AGENT][NEUTRAL] OK, I can help with that. May I have your name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. That's [PII] E. initial is [PII].
[AGENT][POSITIVE] OK, thank you so much. And my first name is [PII]. My last initial is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Mhm thank you.
[AGENT][NEUTRAL] May I also have, you're welcome, and may I have your call back number we are disconnected please?
[CUSTOMER][NEUTRAL] Yes, my direct number is [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the policy number please, Giselle?
[CUSTOMER][NEUTRAL] Yes. Uh, I have here 02511140 M for Mary, L for Lima, and then the number 8.
[AGENT][NEUTRAL] OK, thank you very much. And let me just repeat that to confirm. I have that as 02511140 ML8.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, it's for [PII], [PII].
[AGENT][NEUTRAL] OK, and for eligibility and benefits, I can certainly help you with that. Um, she is the policy holder with an effective date of [PII]. This policy shows active as a secondary.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] For outpatient benefits, please note verification of benefits provided does not guarantee payment. We pay on a per day max. Again, we pay on a per day max of up to $750.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, you said per day or per, per visit? Is that correct?
[AGENT][NEUTRAL] Per day, per calendar day we will pay up to $750.
[CUSTOMER][NEUTRAL] OK, per.
[CUSTOMER][NEUTRAL] Um, that includes any procedure, I mean.
[CUSTOMER][NEUTRAL] Per per day.
[AGENT][NEUTRAL] Would this be inside a doctor's office or clinic or facility?
[CUSTOMER][NEUTRAL] Uh, doctor's office.
[AGENT][NEUTRAL] OK, um, we, the plan will help with the deductible, co-pay, and co-insurance based on coverage, of course, and she does have a writer to help with services inside the office again for coverage services.
[CUSTOMER][NEUTRAL] Mm, OK, um, is there, um, do we need to check if we are in network with the plan or there's no need?
[AGENT][NEUTRAL] Uh, no, there's no need, there's no network for this particular plan. This is a secondary to her major medical.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Secondary, uh-huh. OK. All right. So, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, all right, so can I just have the reference number for the call, please?
[AGENT][NEUTRAL] We do not provide reference numbers to sell. You can use my name in today's date. Would you need any information as far as claim submission?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] Um, yeah, I would just need, I'm not sure, uh, I was just told to get the eligibility probably because the patient was seen.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, so thank you so much I appreciate your help.
[AGENT][POSITIVE] You're welcome, just sell and thank you for calling APL. Have a great day and take care.
[CUSTOMER][POSITIVE] You too. You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye.