AccountId: 011433970860
ContactId: c2624926-37b7-418a-b0dd-80a34d60b03d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 145250 ms
Total Talk Time (AGENT): 82090 ms
Total Talk Time (CUSTOMER): 42383 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/c2624926-37b7-418a-b0dd-80a34d60b03d_20250418T13:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name's [PII]. I'm calling from a facility. I need to let you know that the entire call will be monitored and recorded for quality and compliance purposes. I'm just calling to verify active coverage for a member and then see if you guys need an update to the coordination of benefits or if you even keep one on file at all.
[AGENT][POSITIVE] I'm sure, [PII] I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 02566562
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. Thank you and just let me advise you the verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Um, outpatient.
[AGENT][NEUTRAL] OK, for outpatients, we cover up to 3000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, and do you keep any information on file about the primary or no you don't need it?
[AGENT][NEUTRAL] Um, no, ma'am. Normally, when we receive um claims from the providers, they'll send in the EOB from the um primary insurance company, so we'll know which portion to pay. Um, we keep those claims on file, but as far as listed, no. We don't keep that on file who the primary carrier is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and do you have a reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that is all. Thank you so much for your help, EV have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you, bye.