AccountId: 011433970860
ContactId: bf35c3d9-6e5b-40b3-898d-2d3c1d63944f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185809 ms
Total Talk Time (AGENT): 101010 ms
Total Talk Time (CUSTOMER): 43098 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/bf35c3d9-6e5b-40b3-898d-2d3c1d63944f_20250124T13:48_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] Uh, good morning, [PII]. My name is [PII], and I'm calling from the diagnostic Center of Miami. I need to get eligibility and benefits on a patient, please.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], you're needing eligibility and outpatient benefits, is that correct?
[CUSTOMER][POSITIVE] Yes, outpatient yes ma'am.
[AGENT][POSITIVE] Yes ma'am. I can help you with those, with those things. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It is 02141247 ML 8.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments to get all of the information pulled up, please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today, [PII] 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] OK.
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is a subscriber on the supplemental policy. It is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And her outpatient benefit max per calendar day for covered outpatient services is $500.
[AGENT][NEUTRAL] And there is no outpatient deductible per cover person per calendar day.
[CUSTOMER][POSITIVE] OK great thank you.
[AGENT][NEUTRAL] And just a couple of You're welcome and just a couple of additional things, uh, because this is a supplement to her primary insurance, we must also have a copy of her primary insurance company's explanation of benefits along with the claim for review. And then once we have processed our claim, [PII], you should be able to check claim status for APO by going to our portal at secured.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK great.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much for your assistance. I appreciate it. You have a wonderful day.
[AGENT][POSITIVE] Well, you, absolutely, yes, ma'am. It was my pleasure and thank you again for calling APL Giovanna. I hope you have a great weekend also.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.