AccountId: 011433970860
ContactId: 89ed7a2e-86f1-423e-abf7-3b6c7ae9f36f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250380 ms
Total Talk Time (AGENT): 112063 ms
Total Talk Time (CUSTOMER): 66091 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/89ed7a2e-86f1-423e-abf7-3b6c7ae9f36f_20250128T19:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. My name is [PII], and I'm from International Institute of Sleep. I need to verify um somebody's secondary insurance with you guys.
[AGENT][NEUTRAL] OK, as in coverage, or you need to know if it's active?
[CUSTOMER][NEUTRAL] Yeah, well.
[AGENT][NEUTRAL] OK, both? OK. Well, I can definitely help you with the eligibility and the benefits, and you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] Thank you for that and then the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] Um, I have 02581662.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active. It's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, I think they, um.
[CUSTOMER][NEUTRAL] We're doing a sleep study, a home sleep test.
[AGENT][NEUTRAL] OK, let's see. Hold on one moment.
[AGENT][NEUTRAL] OK, so that's
[AGENT][NEUTRAL] So just for the call again, all the information provided is the verification of benefits, not a guarantee of payment. So for the outpatient benefit, the policy would pay up to $250 per person per day, um, and the sleep study is covered or one of the covered services under outpatient benefits, so it will be that $250 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And it is so the outpatient is covered because a lot of times you guys just your policies are only um hospitalization so this does cover outpatient.
[CUSTOMER][NEUTRAL] Or a sleep study. Do you need the code?
[AGENT][NEUTRAL] No, we don't use codes. Um, just from looking at the policy, it does say um the sleep study center, lab facility, a person's home.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that would be included under um sleep study for outpatient.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, let me just make sure I have the right address for you. One second. Look at my system here and I'll confirm it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is it [PII]?
[AGENT][NEUTRAL] Oh, no, so that's the old one. Let me give you the new mailing address.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] And the um payer ID is that still, let me see.
[CUSTOMER][NEUTRAL] Oh, I don't show it on here. What's the pay ID just to make sure.
[AGENT][NEUTRAL] So it's 60801.
[CUSTOMER][NEUTRAL] OK, alright, sounds good. um, and can I get a reference number for the call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial of my last name is [PII], and again, my first name is [PII]
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome. You also, thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Appreciate it have a good day.
[CUSTOMER][NEUTRAL] OK