AccountId: 011433970860
ContactId: 876175fb-01fd-45de-b05d-dfb8c0b1e216
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213740 ms
Total Talk Time (AGENT): 113555 ms
Total Talk Time (CUSTOMER): 59959 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/876175fb-01fd-45de-b05d-dfb8c0b1e216_20250124T13:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I need uh patients eligibility and benefits.
[AGENT][NEUTRAL] OK, you're needing eligibility and benefit information on a member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you. And who am I speaking with?
[CUSTOMER][NEUTRAL] Jamais
[AGENT][NEUTRAL] Spell your name for me, please, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] [PII]. OK, thank you. And your email, what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 023 04860
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments to get all of the members information pulled up please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] But no I was just more work.
[CUSTOMER][NEUTRAL] OK, that's gonna be so.
[CUSTOMER][POSITIVE] Thank you
[AGENT][NEUTRAL] OK, [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Those are gonna be
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is the subscriber on the supplemental policy. It is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And what type of benefit information are you needing inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I read on it.
[CUSTOMER][NEUTRAL] reschedule.
[CUSTOMER][NEUTRAL] This is open today.
[AGENT][NEUTRAL] OK, Yella, so on this policy, she has an outpatient benefit max of $350 per covered person per calendar day for covered outpatient services, and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And a couple of additional things you mail us, because this is a supplemental policy to your primary insurance, we will also have to have a copy of the primary insurance explanation of benefits along with the claim for review. And then once we've processed our claim, our claim status can be checked by going to our portal at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, is there a reference number?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] What was your name again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Yes, ma'am. Well, you're certainly very welcome. So if that's all you know that I can help you with today, then thank you again for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] You too mhm bye.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye bye.