AccountId: 011433970860
ContactId: 967e3be1-46dd-4715-8f42-095bc46dd642
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206750 ms
Total Talk Time (AGENT): 106583 ms
Total Talk Time (CUSTOMER): 49586 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/967e3be1-46dd-4715-8f42-095bc46dd642_20250130T15:20_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi Ms. [PII], I need to um verify benefits for a member, please.
[AGENT][NEUTRAL] OK. Do you also need eligibility or only benefits?
[CUSTOMER][NEUTRAL] Yes, eligibility and benefits.
[AGENT][POSITIVE] Yes, ma'am. I can help you with both. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It's gonna direct line is gonna be [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Um, 02452349.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it was it out is it outpatient benefits, and inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Yes ma'am, out outpatient.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and [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 please and their date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is a subscriber on the supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she has an outpatient benefit max of $2500 per covered person per calendar year for covered outpatient services.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] At the moment [PII].
[AGENT][NEUTRAL] And when the claim is submitted to APL for review [PII], we will also have to have a copy of her primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] For review and then once we have processed our claim we do have a portal in which claim status should be able to be checked and that portal website for that is secured. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Good in alright thank you so much and can I get a reference number for our call today miss?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Sure. Yes, ma'am. You're gonna use my name [PII] along with today's date.
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Alright, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] All right, Ms. [PII], thank you so much for your help.
[AGENT][POSITIVE] Well, you are absolutely, it was my pleasure. So is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am, that's it.
[AGENT][POSITIVE] OK, well thank you again for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.