AccountId: 011433970860
ContactId: bed14cc4-d72f-49b8-a7bc-301b4938425f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 488399 ms
Total Talk Time (AGENT): 139024 ms
Total Talk Time (CUSTOMER): 211439 ms
Interruptions: 8
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/bed14cc4-d72f-49b8-a7bc-301b4938425f_20250424T18:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling on behalf of Townsend Memorial, and I'm calling to get um benefits and eligibility for a member and status if we are in network.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] I can help you with eligibility and benefits today.
[AGENT][NEUTRAL] Do you have the policy number on you?
[CUSTOMER][NEUTRAL] It's 02107801.
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] OK, [PII], and then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] OK [PII], and then what's a good call back number in case our call gets? Sure, my direct number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Extension [PII].
[AGENT][NEUTRAL] OK, and then the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] And then the patient's first and last.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, so it looks like the policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] OK, so it looks like the policy is active.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is he the policy holder or is he a dependent on there?
[AGENT][NEUTRAL] He is not. He is a dependent.
[CUSTOMER][NEUTRAL] He is not. He
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the policy holder, is it Mr. [PII]?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and what is the benefit period?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Do you mean the date paid to?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it is [PII].
[CUSTOMER][NEUTRAL] OK, it is [PII].
[AGENT][NEUTRAL] OK. And then you wanted to check benefits today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this an office visit?
[CUSTOMER][NEUTRAL] Is this an Outpatient hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, just one second while I pull up his benefits.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment. It's just a verification of coverage.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So it looks like the outpatient benefit max is 500 per covered person per calendar year, and that's a max of 1500 per calendar year.
[CUSTOMER][NEUTRAL] So it looks like the outpatient benefit max is 500 per covered person per calendar year and that's a max of 1500 per calendar year.
[CUSTOMER][NEUTRAL] OK, have they met any of that?
[AGENT][NEUTRAL] I can double check for you. Just a second.
[CUSTOMER][NEUTRAL] I can double check
[AGENT][NEUTRAL] No, they have not used anything as of this year.
[CUSTOMER][NEUTRAL] No they have not used anything as of this year. OK, um.
[CUSTOMER][NEUTRAL] Can you check if authorization is required for our outpatient procedure if I give you the CPT code?
[AGENT][NEUTRAL] No, ma'am. Authorization is not required.
[CUSTOMER][NEUTRAL] No ma'am authorization is not required. OK, can you check um network status?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so this is a meddling policy there we are not in network with any certain provider.
[CUSTOMER][NEUTRAL] OK, so this is a memory.
[CUSTOMER][NEUTRAL] We are not in network with any certain providers. OK, can I have your group numbers?
[AGENT][NEUTRAL] Of course, so their group number is 24994.
[CUSTOMER][NEUTRAL] Of course, so their group number is 24994.
[CUSTOMER][NEUTRAL] OK, and can I have you all's claims mailing address?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] That will be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is your all um claims timely filing period?
[AGENT][NEUTRAL] There is no filing limit.
[CUSTOMER][NEUTRAL] There is no filing limit. OK.
[CUSTOMER][NEUTRAL] Hi [PII], can I get the initial of your last name and a call reference number please?
[AGENT][NEUTRAL] Of course, it's [PII]
[CUSTOMER][NEUTRAL] Of course it's [PII]
[AGENT][NEUTRAL] And then the call reference number would be my first name, [PII]
[CUSTOMER][NEUTRAL] And then the call reference number would be my first name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Last initial [PII] and then today's date.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Last initial [PII] and then today's date. OK, thank you so much [PII] uh do do.
[AGENT][NEUTRAL] Of course. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] feeling like I'm forgetting to ask you something.
[AGENT][NEUTRAL] So you asked for network?
[CUSTOMER][NEUTRAL] OK, and what is ATL stands?
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Yes. Oh,
[AGENT][NEGATIVE] All oh, sorry. Oh jeez.
[CUSTOMER][NEUTRAL] All of the OK what have you.
[AGENT][NEUTRAL] Oh, just a second. I know this, why am I?
[CUSTOMER][POSITIVE] I love this
[AGENT][NEUTRAL] American Public Life. Oh my.
[CUSTOMER][NEUTRAL] American Public Life.
[AGENT][NEUTRAL] It's like a Monday, I swear.
[CUSTOMER][NEUTRAL] That's OK, yeah.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK. And we said um there's no deductible out of pocket. However, the patient, the members have a $500 coverage up to $1500 per calendar year, and they've met zero of that.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Yes ma'am OK.
[CUSTOMER][NEGATIVE] Yeah we've met none of it.
[CUSTOMER][NEUTRAL] OK, no deductible right.
[CUSTOMER][NEUTRAL] I think that is all, [PII].
[AGENT][POSITIVE] Oh, OK. Sounds good. Well, thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Sounds good thank you for calling. Have a good day. Thank you. You as well bye bye.
[AGENT][POSITIVE] Thank you. Bye.
[CUSTOMER][NEUTRAL] Bye bye.