AccountId: 011433970860
ContactId: b1190d33-d793-4bfb-81e2-2e8127195067
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229529 ms
Total Talk Time (AGENT): 127300 ms
Total Talk Time (CUSTOMER): 60821 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/b1190d33-d793-4bfb-81e2-2e8127195067_20250113T14:52_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] Hey, good morning, [PII]. My name is [PII], and I just need to uh verify a patient's uh secondary insurance um that she has with you, APL.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII]. So are you needing to verify benefits and eligibility or just one or the other?
[CUSTOMER][NEUTRAL] Uh, both, please.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Well, looking at the card, I don't even see it, um.
[CUSTOMER][NEUTRAL] The group number not patient benefit certification number, would that be it? OK. 02353132 M as in Mike L as in Lima and the number 8.
[AGENT][NEUTRAL] And depending, depending on the.
[AGENT][NEUTRAL] Yes, sir, that's it. Uh-huh.
[AGENT][POSITIVE] OK, thank you. So give me a couple of moments to get the all of the information pulled up, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK [PII], 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] It is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I do show that she is a subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefits are you needing for her inpatient, outpatient, or office?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient physical therapy, please.
[AGENT][NEUTRAL] OK, so on this policy her outpatient benefit max per calendar year for covered outpatient services is $2000 with no outpatient deductible per covered person per calendar year.
[CUSTOMER][POSITIVE] OK, great.
[AGENT][NEUTRAL] And when the claim, oops, I'm sorry, when the claim is submitted to us for review, since this is a supplement to her primary insurance, we will have to have a copy of her primary insurance company's explanation of benefits also.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I don't know, you may already be familiar with our portal [PII] but we do have a portal in which you can set up your profile to have access to the EOBs and claim status once we have processed her claim, and that website for our portal is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. OK, very good.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK. Well, can I help you with anything else?
[CUSTOMER][POSITIVE] Well, thank you very much. Um.
[CUSTOMER][NEUTRAL] Just a call reference number please and I'll be all set.
[AGENT][NEUTRAL] OK, well, my, you will use my name along with today's date.
[CUSTOMER][NEUTRAL] And what was your first name again? I'm sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. OK. Thank you, [PII]. I appreciate your help.
[AGENT][POSITIVE] Yes, sir. Well, you're welcome. Absolutely. It was my pleasure and thank you again for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Uh, thank you. Bye-bye.