AccountId: 011433970860
ContactId: a6f0fbaa-1ff4-46ec-b746-094a9d80f658
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206630 ms
Total Talk Time (AGENT): 97728 ms
Total Talk Time (CUSTOMER): 46129 ms
Interruptions: 2
Overall Sentiment: AGENT=2.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/a6f0fbaa-1ff4-46ec-b746-094a9d80f658_20250409T15:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I was calling to get outpatient benefits for patients.
[AGENT][NEUTRAL] OK, [PII], you're needing outpatient benefit.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And [PII], do you also need eligible benefits?
[AGENT][NEUTRAL] Information.
[CUSTOMER][NEUTRAL] Uh, well, yeah, to know if she's active as well.
[AGENT][POSITIVE] Yes, I can help you with both things and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] It's 02541075.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And [PII], any information that is provided today would 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] [PII], uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is a subscriber on this policy. This supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so she has an outpatient benefit maximum of $2000 per covered person per calendar day.
[AGENT][NEUTRAL] For covered outpatient services and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And because this is a supplemental policy related to her primary insurance when the claim is submitted to APL we will also have to.
[AGENT][NEUTRAL] Have a copy of her primary insurance company of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal in which you should be able to check our claim status and our portal website is located at secured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's OK because I don't work in claims. Sorry, I just, I don't need the benefits.
[CUSTOMER][NEUTRAL] We have like a separate department for processing claims, um, but thank you for the information. Um, those were the only questions I had in regards to the benefit. No, no, no, it was just for that. Thank you again.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with?
[AGENT][POSITIVE] OK. All right. Well, then, thank you for calling APL and I hope you have a very nice day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.