AccountId: 011433970860
ContactId: 9a894f42-71a4-4ced-9513-33e6d2daca77
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221250 ms
Total Talk Time (AGENT): 102243 ms
Total Talk Time (CUSTOMER): 53816 ms
Interruptions: 0
Overall Sentiment: AGENT=2.8, CUSTOMER=3.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/9a894f42-71a4-4ced-9513-33e6d2daca77_20250604T12:01_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a hospital. I just need to get benefits for a patient, please.
[AGENT][NEUTRAL] OK, [PII], you do not need eligibility, you're only needing benefits. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please [PII].
[CUSTOMER][NEGATIVE] It is gonna be oh I just lost it in front of me.
[CUSTOMER][NEUTRAL] It says outpatient benefit it's 02255775 M as in Mary, L as in Lima 8.
[AGENT][POSITIVE] Thank you one moment please.
[AGENT][NEUTRAL] And any information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII]. She's a dependent.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and what type of benefit information do you need on the supplemental policy inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] It's gonna be outpatient hospital for an EEG. I have a CPT codes if you need them.
[AGENT][NEUTRAL] No, I don't need that.
[AGENT][POSITIVE] Thank you guys.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, so on this supplemental policy, the outpatient benefit max per calendar year for covered outpatient services is $1000 per covered person, and there is no outpatient deductible per cover person per calendar year because this is a uh supplemental policy 7 to the primary insurance we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then once we have processed our claim here we do have a portal in which you should be able to check claim status and the website for our portal is located at [PII].
[CUSTOMER][POSITIVE] Perfect. So, and has she used any of the 1000 yet?
[AGENT][POSITIVE] I can check that for you.
[CUSTOMER][POSITIVE] Thank you I appreciate it.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEGATIVE] And as of now, no ma'am, no benefits have been used for this calendar year.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect and can I have your name one more time? I'm sorry?
[AGENT][NEUTRAL] [PII] and my name in today's date will be your call reference number.
[CUSTOMER][POSITIVE] Awesome, and [PII], can I have the first initial to your last?
[AGENT][NEUTRAL] [PII], and yours?
[CUSTOMER][NEUTRAL] It's uh it's [PII], sorry.
[AGENT][NEUTRAL] OK. All right. OK, [PII], well, again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] That's about it thank you so much I really appreciate it.
[AGENT][POSITIVE] Well, you're very welcome and thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Yes ma'am, thank you. Bye bye.