AccountId: 011433970860
ContactId: 96212a24-b3ec-428c-bc55-1d4fa39ed345
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219119 ms
Total Talk Time (AGENT): 113839 ms
Total Talk Time (CUSTOMER): 55507 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/96212a24-b3ec-428c-bc55-1d4fa39ed345_20250207T20:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], good afternoon. I'm calling from a facility, um, we're a provider and I have a patient that's coming into our facility on Monday for an MRI and has a deductible responsibility with the primary and gave this.
[CUSTOMER][NEUTRAL] Um, gap information I needed to check her, her benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so do you also need eligibility or only benefit information for this number? Both?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Both, please. Both, yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that, and who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you and [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please [PII].
[CUSTOMER][NEUTRAL] It's 02415265 ML8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And also that 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 and their date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. He is the patient. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so I do show that he is a subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And he has an outpatient benefit maximum per calendar day for covered outpatient services of $400 and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. OK. May I have a reference number for that, [PII]?
[AGENT][NEUTRAL] Yes ma'am. We will actually use my name along with today's date and the first initial I'll go to my last name is [PII], and just a couple of additional things because this is a supplemental policy, when the claim is submitted to APL for review, we must also receive a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status and also have access to our EOB and our portal website for that is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you for that.
[AGENT][POSITIVE] Yes ma'am, you're certainly welcome. So is there anything else that I could help you with today?
[CUSTOMER][POSITIVE] no that's all thank you I appreciate your help.
[AGENT][POSITIVE] Well, you're very welcome and thank you for calling APL. I hope you have a very nice weekend.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you