AccountId: 011433970860
ContactId: 80aaf355-9295-424f-90e3-823676cabd3d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265339 ms
Total Talk Time (AGENT): 128279 ms
Total Talk Time (CUSTOMER): 45538 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/80aaf355-9295-424f-90e3-823676cabd3d_20250522T13:03_UTC.wav
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[AGENT][POSITIVE] Thank you for calling HPO. This is. How can I help you?
[CUSTOMER][NEUTRAL] Um, good morning. My name's [PII]. I'm calling to verify benefits, please.
[AGENT][NEUTRAL] OK, [PII], you needing to verify benefits for a member, do you also need eligibility or just benefits?
[CUSTOMER][NEUTRAL] Uh, eligibility also.
[AGENT][NEUTRAL] Yes, sir. I can help you with that, with both things. And what is your callback number please, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] 02456392
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and I'll send any information that is provided 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]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now, the policy number that you provided for me is, is this for a future data service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, let's see, he scheduled.
[CUSTOMER][NEGATIVE] Yes, for actually no for today.
[AGENT][NEUTRAL] OK. So the policy number you gave me is, is an older policy number that's no longer active. That one termed [PII], but there is another policy that is currently active. So give me just a moment and let me get that information pulled up for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] So the current active policy number that you should have.
[AGENT][NEUTRAL] will be 02578882.
[AGENT][NEUTRAL] And this policy has an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And give me another moment please [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um, outpatient for, uh, physical therapy.
[AGENT][NEUTRAL] OK, so on this supplemental policy, [PII], the outpatient benefit maximum per calendar year for covered outpatient services is $6000 with no deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And because it is a supplement to the primary insurance, when the claim is submitted to us for review, we will have to have a copy of his primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Certainly.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status.
[AGENT][NEUTRAL] And the website for our portal is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I think maybe you have access to the portal.
[AGENT][POSITIVE] OK, good.
[CUSTOMER][POSITIVE] OK perfect I appreciate your help today.
[AGENT][NEUTRAL] I was
[AGENT][POSITIVE] Absolutely. You're very welcome. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Uh, no, that'll be it. Thank you. You have a great day.
[AGENT][POSITIVE] I hope you have a great day too, [PII], and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Alright bye bye.
[AGENT][NEUTRAL] Bye bye.