AccountId: 011433970860
ContactId: 82d0f8a6-3d5e-4efb-a9b4-1dbc382726b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230679 ms
Total Talk Time (AGENT): 71737 ms
Total Talk Time (CUSTOMER): 73076 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/82d0f8a6-3d5e-4efb-a9b4-1dbc382726b3_20250331T15:48_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII], how are you? My name is [PII] and I'm calling to verify members eligibility.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And [PII], do you have the patient, um, policy number?
[CUSTOMER][NEUTRAL] Yes, that is 02440192 ML8.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] And Zobra, [PII].
[AGENT][NEUTRAL] Uh, it looks like they have a more recent policy number. This one that you gave me termed 11. Let me give you the new policy number if that's OK.
[CUSTOMER][POSITIVE] Sure, of course, thank you.
[AGENT][NEUTRAL] It's 245-1595.
[CUSTOMER][NEUTRAL] OK, I have 2451595.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that
[AGENT][NEUTRAL] You said that was for info, is that right?
[CUSTOMER][NEUTRAL] Yes, and so brawn.
[AGENT][POSITIVE] Yeah, OK perfect.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment. It's a basic outline of the policy.
[AGENT][NEUTRAL] Is this for outpatient services or?
[CUSTOMER][NEUTRAL] Yes, outpatient, outpatient hospital.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Get that pulled up.
[AGENT][NEUTRAL] OK, so for outpatient services they have a $500 per covered person per calendar day benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For calendar date.
[CUSTOMER][NEUTRAL] And let's see here is the what is the group number?
[AGENT][NEUTRAL] Uh, group number is.
[AGENT][NEUTRAL] Group number is 18693.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And just to confirm, um, is prior of required?
[AGENT][NEUTRAL] No prior authors required.
[CUSTOMER][NEUTRAL] OK. And this is just a secondary gap plan or a secondary plan, medical plan?
[AGENT][NEUTRAL] Yeah, it's a secondary supplemental policy, so be sure to file with the primary EOB.
[CUSTOMER][NEUTRAL] Perfect. Um, is there a policy effective date? Would it be [PII] of this year?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And acting.
[CUSTOMER][POSITIVE] 0, [PII] OK and active perfect.
[CUSTOMER][NEUTRAL] OK, and just to confirm that claims address is [PII]?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Awesome thank you so much. Is there a call reference number?
[AGENT][NEUTRAL] A call reference number would just be my first name, [PII], last initial [PII], today's date. And anything else I can help with today, [PII]?
[CUSTOMER][POSITIVE] No, that was it thank you so much appreciate the help and happy Monday.
[AGENT][POSITIVE] OK, thank you. You as well.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] Bye.