AccountId: 011433970860
ContactId: be12da5a-2b41-4a53-b2cb-6dd7e99245f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218779 ms
Total Talk Time (AGENT): 104798 ms
Total Talk Time (CUSTOMER): 68296 ms
Interruptions: 1
Overall Sentiment: AGENT=2.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/be12da5a-2b41-4a53-b2cb-6dd7e99245f4_20250325T20:01_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 [PII], good afternoon. My name is [PII]. I'm calling from the Diagnostic Center of Miami. How are you doing today?
[AGENT][NEUTRAL] I'm good. And did you say your name is [PII]? Is that?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Oh, I'm so sorry, myself, thank you. And I'm fine and how are you doing today?
[CUSTOMER][NEUTRAL] No, no, no way.
[AGENT][NEUTRAL] OK
[CUSTOMER][POSITIVE] I'm doing well thank you for asking. I just need to obtain benefits and eligibility.
[AGENT][POSITIVE] Good. Well, how?
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you're needing eligibility and benefit information, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes ma'am, I can help you with that, and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] [PII] 4.
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] It is 02300494 M like Mary, L like Larry, and then the number 8 at the end.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[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 please and their date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII], [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on the supplemental policy, and this supplemental policy is active. The effective date is going to be [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] outpatient benefits.
[AGENT][NEUTRAL] Outpatient, OK.
[AGENT][NEUTRAL] So she has an outpatient benefit max for covered outpatient services of $500 with no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] $500 per calendar day.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, [PII], may I have a reference number for this call, please?
[AGENT][NEUTRAL] Yes ma'am, you will actually use my name along with today's date and then the sale once when the claim is submitted to.
[CUSTOMER][NEUTRAL] You're going back?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII] for review, we will also have to have a copy of the explanation of benefits along with the claim.
[CUSTOMER][POSITIVE] Oh my gosh.
[AGENT][NEUTRAL] And then once the claim has been processed, we do have a portal that you should be able to check claim status by going to [PII].
[CUSTOMER][NEUTRAL] OK, you
[CUSTOMER][NEUTRAL] OK, [PII] and the confirm the reference number is your name and today's date, right?
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][POSITIVE] All right, perfect. Thank you so much. You have a wonderful evening. OK, bye bye thank you bye bye.
[AGENT][POSITIVE] OK. Well, yes, ma'am. Well, you're very welcome. You too. Thank you again for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.