AccountId: 011433970860
ContactId: a96ad2c5-4aa3-442b-a985-77c3d7c1db00
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271970 ms
Total Talk Time (AGENT): 151743 ms
Total Talk Time (CUSTOMER): 144705 ms
Interruptions: 11
Overall Sentiment: AGENT=1.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/a96ad2c5-4aa3-442b-a985-77c3d7c1db00_20250502T17:24_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] OK, thank you for calling.
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I'm with the provider's office, medical, and I'm trying to figure out this patient just called with this policy. If you cover medical, you know, so the primary insurance paid left to balance, then are we able to bill you guys?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm sorry, did you say that your name is [PII]? Is that correct?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] is that correct? OK, alright, yes ma'am. OK, and [PII], you're just wanting to get some benefit information on the type of plan that the member has with APL is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and.
[CUSTOMER][POSITIVE] Yeah. Great. Yeah.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII] and that's direct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, perfect, thank you and what is the member's policy number please [PII]?
[CUSTOMER][POSITIVE] Perfect thank you and what is the number?
[CUSTOMER][NEUTRAL] 02267455
[AGENT][POSITIVE] OK, thank you so give me just a couple of moments please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] And any information that I do provide for you today calling with the verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] 42 days following the verification effective.
[CUSTOMER][NEUTRAL] your
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] We have to
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so I do show [PII] that he is a subscriber on the supplemental policy and it is active with an effective date of [PII], and this policy is a supplemental policy to his primary health care insurance that helps with co-pays, deductibles and co-insurance amounts of covered services.
[CUSTOMER][NEUTRAL] on the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] pay deduct the payment services.
[AGENT][NEUTRAL] So what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, he was an outpatient, so I guess at this point I just need to get the claim to you with the primary EOB.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what they paid.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Correct, cause he has an out.
[CUSTOMER][NEUTRAL] Um, is there a special place?
[AGENT][NEUTRAL] Oh, I'm so sorry, so you don't need the benefit amount for his max on this policy?
[CUSTOMER][NEUTRAL] No, I, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, just one sec.
[AGENT][NEUTRAL] Let me change just one thing here please.
[AGENT][NEUTRAL] And so yes ma'am, we will also and you did say this but I wanna just make sure I understood you correctly you do know that we will have to have a copy of his primary insurance EOB along with the claim.
[CUSTOMER][NEUTRAL] OK yes ma'am, we will also if I wanted to make sure I understood you correctly.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, and then calling once the claim has been processed by APL, we do have a portal that you should be able to check our claim status in for him, and the website for that is [PII]
[CUSTOMER][POSITIVE] Alright, perfect.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me do have a you should be able to check our current status.
[CUSTOMER][NEUTRAL] And the website for that.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you, do you need the claim's mailing address?
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] OK, it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. Alright, I appreciate all your assistance.
[AGENT][POSITIVE] Well, you are certainly very welcome. Is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No, that was perfect.
[AGENT][POSITIVE] OK [PII], well thank you so much for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] You too now bye.
[AGENT][POSITIVE] Yes ma'am thank you bye bye.
[CUSTOMER][POSITIVE] Thank