AccountId: 011433970860
ContactId: c9426e61-fdaf-4372-8ed7-38a7becc6657
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227059 ms
Total Talk Time (AGENT): 105304 ms
Total Talk Time (CUSTOMER): 43069 ms
Interruptions: 1
Overall Sentiment: AGENT=2.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/c9426e61-fdaf-4372-8ed7-38a7becc6657_20250108T13:39_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] Yes, hi [PII], my name is [PII]. I'm calling from a provider's office. I need to verify benefits for a patient, please.
[AGENT][NEUTRAL] OK, [PII], you're needing to verify benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that. Do you also need eligibility or strictly benefits?
[CUSTOMER][POSITIVE] Just the benefits.
[AGENT][NEUTRAL] OK, yes ma'am, I can help you. And what is your callback number please, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 02552666
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And are you going to need inpatient, outpatient or office benefits today?
[CUSTOMER][NEUTRAL] outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so any information that I do provide for you today will be a verification of benefits, [PII], and not a guarantee of payment. What is your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII]. I mean [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so on this policy, the supplemental policy, she is the subscriber, this policy, uh, you didn't need the effective date you already had that, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, so the outpatient benefit maximum for covered outpatient services is $8000 per calendar year with no deductible.
[AGENT][NEUTRAL] And when the claim is submitted to APL [PII], we will also have to have a copy of her primary insurance company's explanation of benefits for review.
[AGENT][NEUTRAL] And then once the claim has been processed with APL you may obtain the explanation of benefits.
[AGENT][POSITIVE] It's by going to our portal it's secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect can I have a call reference number please?
[AGENT][POSITIVE] Sure, you would actually use my name along with today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much, [PII] I appreciate the help.
[AGENT][POSITIVE] OK, well, you're very welcome. Absolutely it was my pleasure. Is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK, well then thank you again for calling APO and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.