AccountId: 011433970860
ContactId: bbb96c0a-411a-4091-b4ba-a18a59409525
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225949 ms
Total Talk Time (AGENT): 116100 ms
Total Talk Time (CUSTOMER): 45860 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/bbb96c0a-411a-4091-b4ba-a18a59409525_20250305T17:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], I'm calling to verify benefits for a patient.
[AGENT][NEUTRAL] OK, do you also need eligibility or do you only need benefits?
[CUSTOMER][NEUTRAL] Yes, both, please.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] Um, 01923350 ML 8.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] And any information that I do provide will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] OK, so I do show that he is a subscribery on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need from for him rather inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Outpatient, OK.
[AGENT][NEUTRAL] OK, so on this supplemental policy, he has an outpatient benefit maximum of $1000.
[AGENT][NEUTRAL] Per calendar day for covered outpatient services and there is no outpatient deductible per covered person per calendar day.
[AGENT][NEUTRAL] Because this is a supplemental policy levied to the primary insurance, we will also have to have a copy of the primary insurance EOB along with the claim.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status and by going to secured. [PII].
[CUSTOMER][NEUTRAL] OK, and.
[CUSTOMER][NEUTRAL] So effectively 81 2020 and it is 1000 per day for out of outpatients.
[AGENT][NEUTRAL] Yes ma'am, for covered outpatient services, yes, it is a per calendar day benefit of $1000 excuse me, benefit maximum of $1000 for covered services.
[CUSTOMER][NEUTRAL] And is there.
[CUSTOMER][NEUTRAL] And Ms. [PII], is there a reference number for the call?
[AGENT][POSITIVE] Yes, ma'am, you would actually use my name along with today's date.
[CUSTOMER][POSITIVE] Thank you so much. I hope you have a great rest of your day.
[AGENT][POSITIVE] Well, I hope you do too. And if that, is there anything else I can help you with?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] OK, well, you're welcome and again thank you for calling APL have a wonderful afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.