AccountId: 011433970860
ContactId: ac58d2ff-78aa-4a58-9de7-29e96860e7e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232770 ms
Total Talk Time (AGENT): 122773 ms
Total Talk Time (CUSTOMER): 52027 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=3.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/ac58d2ff-78aa-4a58-9de7-29e96860e7e6_20250620T20:34_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] Hi, good afternoon, [PII]. I am calling to verify the insurance for one of my patients.
[AGENT][NEUTRAL] OK, are you needing eligibility or eligibility and benefits?
[CUSTOMER][NEUTRAL] Eligibility and benefits.
[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][NEUTRAL] Thank you. And may I, what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] 01416644 M as in Mary, L as in Lima, 7.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And 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] The first name is [PII], middle name [PII], last name [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that he is the subscriber on the supplemental policy and it is active May with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] It will be outpatient.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] So on the supplemental policy, the outpatient benefit maximum per calendar year for covered outpatient services is $1000.
[AGENT][NEUTRAL] And there is no outpatient deductible.
[CUSTOMER][POSITIVE] Perfect. Mm.
[AGENT][NEUTRAL] And as as of now he has not used any of the benefits for this calendar year.
[AGENT][NEUTRAL] Now, because it
[CUSTOMER][POSITIVE] Perfect, so may I please have the, yeah, go ahead.
[AGENT][NEUTRAL] Oh, yeah, just a couple more things, May, um, because it is a supplemental policy when the claim is submitted to us for review, we will also have to have a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed the claim at APL we do have a portal that you should be able to check claim status in and the website for our portal is located at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] May, are you still there? OK.
[CUSTOMER][POSITIVE] Yes, yes, I'm here. Perfect. May I please have the call reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am, you would reduce my name along with today's date.
[CUSTOMER][POSITIVE] Thank you so much [PII] I greatly appreciate your help today.
[AGENT][POSITIVE] You. Oh, you're welcome, May. It was my pleasure in helping you. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that will be all for today. Thank you.
[AGENT][POSITIVE] OK, well, you're welcome and thank you again for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Thank you have a great weekend.
[AGENT][POSITIVE] Yes, ma'am. Thank you.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye.