AccountId: 011433970860
ContactId: 8ddb25e8-e3b7-46b4-bd88-d5f94da1e9c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166470 ms
Total Talk Time (AGENT): 105080 ms
Total Talk Time (CUSTOMER): 41252 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/8ddb25e8-e3b7-46b4-bd88-d5f94da1e9c4_20250226T20:59_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from Gastro Associates. I need to verify benefits please.
[AGENT][NEUTRAL] OK, [PII], you're needing to verify uh eligibility and benefits for a member. Is that correct? Yes, ma'am, I can help you with that. And [PII], what is a good callback number for you, please?
[CUSTOMER][POSITIVE] Yes ma'am mhm mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's 02465458.
[AGENT][NEUTRAL] OK, thank you, one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If I could get my fingers on the right keys [PII], it would be most helpful.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] It the day's almost done. It's all right.
[AGENT][NEUTRAL] Yeah, they're about typed out today too. I mean that's probably part of the issue. OK, so any information, [PII] that I do provide for you 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] Oh [PII] date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I do show that she is the subscriber on the supplemental policy, [PII], and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] For a specialist office visit?
[AGENT][NEUTRAL] OK, so on this supplemental policy, it does not cover office visits. There are not any benefits for office visits, however, if she receives some form of treatment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In the office, she does have an office treatment writer that we could review treatment under her outpatient benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, OK, that's all I needed to know, thank you so much.
[AGENT][NEUTRAL] OK. Well, you're certainly welcome. And if you all end up filing a claim with us, [PII], for her, please include, we do have to have the primary insurance company's explanation of benefits as well. And then also if you do file with us, we have a portal that you should be able to check claim status in once we've processed our claim and the website for that is [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] OK, OK, well then, thank you again for calling APL if that's all I can help with and I hope you have a nice evening.
[CUSTOMER][NEUTRAL] Alright, mhm.
[CUSTOMER][NEUTRAL] You as well alright bye bye now.
[AGENT][POSITIVE] Thank you. Bye-bye.