AccountId: 011433970860
ContactId: af5e1790-ddda-4bdd-a600-c0b93df13d82
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210919 ms
Total Talk Time (AGENT): 102618 ms
Total Talk Time (CUSTOMER): 40040 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/af5e1790-ddda-4bdd-a600-c0b93df13d82_20250220T13:13_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] [PII], hi, I'm calling from NMed. I need um benefits on a patient please.
[AGENT][NEUTRAL] OK, do you also need eligibility or did you already have that and you're just needing benefits?
[CUSTOMER][NEUTRAL] Um, just benefits, please.
[AGENT][POSITIVE] Yes, I can help you and who am I speaking with?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and Dad, what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your, the member's policy number that you're calling about?
[CUSTOMER][NEUTRAL] It is 02456511.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] Daddy, or can you hear me?
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I don't know why my system automatically muted our calls, so I know you didn't hear anything I said, but any in 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 and their date of birth?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] No, I didn't.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what type of benefit information are you needing on the supplemental policy inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um, outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So he has an outpatient benefit maximum for covered outpatient services per calendar day of $500 and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK, so $500 per calendar day max.
[AGENT][NEUTRAL] And because
[AGENT][NEUTRAL] Correct for covered outpatient services, yes ma'am. And when the claim is submitted DD to APL for review, we will also have to have a copy of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] As well, and then once we have processed our claim, we do have a portal that you should be able to check claim status and also have access to our explanation of benefits and our portal website is secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much you have a great day.
[AGENT][POSITIVE] I hope you do too and if that's all I can help you with then thank you again for calling APL.
[CUSTOMER][POSITIVE] OK, thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.