AccountId: 011433970860
ContactId: 8d76cf6b-441f-4571-a1ba-bc37894fefee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155160 ms
Total Talk Time (AGENT): 73598 ms
Total Talk Time (CUSTOMER): 58503 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/8d76cf6b-441f-4571-a1ba-bc37894fefee_20250425T18:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi [PII], I'm trying to see if I can get benefits.
[AGENT][POSITIVE] OK. I'm happy to check on benefits for you. Do we have a policy number?
[CUSTOMER][NEUTRAL] Uh, yes, I do, uh, let me see.
[CUSTOMER][NEUTRAL] It is 021-97342.
[AGENT][NEUTRAL] Alright, let me take a look here.
[AGENT][NEUTRAL] And if I could get the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Um, it's for [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you so much. So, patient is active. Effective date on here is [PII].
[AGENT][NEUTRAL] Were the members secondary insurance, so this will cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] OK, and coinsurance, got it. Is there a certain amount? Is this like a limited benefit plan or?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, it's their secondary so it's gonna pick up anything from the primary. There is a limit um their outpatient benefit amount for the calendar year is 2550. Looks like it's the same limit for inpatient, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And did, does it.
[CUSTOMER][NEUTRAL] Show the accumulation so far for this year or do you see that or?
[AGENT][NEUTRAL] Mm, yeah, it looks like they have not used anything as of today.
[CUSTOMER][NEUTRAL] OK, 0, perfect. So then basically do is do you guys require an authorization for an observation state?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, we do not. So we pick up any deductible, co-pay, co-insurance from the primary, um, as their secondary, so we do not require any prior authorization.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and this is American Public Life and the claims address is [PII]?
[AGENT][NEUTRAL] Yes, ma'am, that is correct. We do also have a fax and payer ID if you would like that.
[CUSTOMER][NEUTRAL] Uh, no, that's fine. Do you have a reference number or is it just your name?
[AGENT][NEUTRAL] It's just my name with today's date.
[CUSTOMER][NEUTRAL] The initial to your last name if you don't mind.
[AGENT][POSITIVE] No, not a problem. It's gonna be [PII].
[CUSTOMER][POSITIVE] OK, thank you [PII] you have a great weekend thank you so much for your help.
[AGENT][NEUTRAL] You too. Bye-bye.