AccountId: 011433970860
ContactId: ba995db6-8578-4a3d-9dac-9c28f51db481
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213250 ms
Total Talk Time (AGENT): 108096 ms
Total Talk Time (CUSTOMER): 30457 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/ba995db6-8578-4a3d-9dac-9c28f51db481_20250108T14:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I was calling to get benefits and eligibility on a patient please.
[AGENT][NEUTRAL] OK, [PII], you're needing benefits and eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 02100356
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And [PII], any information that I do provide today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And any information again that I do provide for you today would be a verification of benefits and not a guarantee of payment. Uh, are you needing, uh, first off, she is the spouse of the subscriber. I'm sorry, I'm repeating myself this morning. My goodness. Uh.
[CUSTOMER][POSITIVE] It's OK. You're OK.
[AGENT][NEUTRAL] And this this supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And are you needing inpatient, outpatient or office benefits for this member?
[CUSTOMER][NEUTRAL] Outpatient please.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so the outpatient benefit maximum is $1000 per covered person per calendar day for covered outpatient services.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] And there's no outpatient deductible per covered person per calendar day.
[CUSTOMER][POSITIVE] Perfect, OK.
[AGENT][NEUTRAL] And with this type of policy, you may already be aware of this, [PII], but we do have to have a copy of the primary insurance company's explanation of benefits along with the claim.
[AGENT][NEUTRAL] And then once our claim has been processed to an APL, you should be able to access the EOB and check claim status by going to our portal at [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much, [PII] for your help and have a wonderful day.
[AGENT][POSITIVE] OK. Will you absolutely. I hope you have a wonderful day too, and that's all I can help you with, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you goodbye.
[AGENT][POSITIVE] Mhm. You're welcome. Bye bye.