AccountId: 011433970860
ContactId: 84b9f76d-ad6c-4eb4-80af-9972fd915a3e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227410 ms
Total Talk Time (AGENT): 117464 ms
Total Talk Time (CUSTOMER): 45162 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/84b9f76d-ad6c-4eb4-80af-9972fd915a3e_20250619T12:14_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, I need to check the patients got policy.
[AGENT][NEUTRAL] OK, when you say check on it, what do you mean by that? Are you needing benefits and eligibility?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you with those things. And who am I speaking with?
[CUSTOMER][NEUTRAL] Jamais
[AGENT][NEUTRAL] And it's [PII], is that correct?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] OK, thank you. And your, what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 02509936
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And toil us any information that I do provide for you today 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] Yeah
[CUSTOMER][NEUTRAL] in
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so I do show that he is the spouse of the subscriber.
[AGENT][NEUTRAL] And his coverage is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Outpatient
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so on this supplemental policy, the outpatient benefit maximum per calendar day for covered outpatient services is $500 and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Have
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Because
[AGENT][NEUTRAL] And because it is a supplemental policy, you email us to his primary insurance, we will have to have a copy of his primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then we do have our portal in which you all should be able to check our claim status once the claim has been processed by APL and that website for the portal is located at [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, um, is there a reference number?
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][NEUTRAL] And what was your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Well, you're welcome, [PII] and again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] OK, well thank you again for calling APL and I hope you have a very nice day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.