AccountId: 011433970860
ContactId: cc7d4478-972e-417e-a43e-e0fe76862a59
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277679 ms
Total Talk Time (AGENT): 143783 ms
Total Talk Time (CUSTOMER): 74209 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/cc7d4478-972e-417e-a43e-e0fe76862a59_20250529T12:02_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] Hi, good morning, my name is [PII]. I'm calling because I need to check patient benefit.
[AGENT][NEUTRAL] OK, [PII], you need benefits only. You do not need eligibility as well, is that correct?
[CUSTOMER][NEUTRAL] Yeah, well I need both.
[AGENT][NEUTRAL] You need both? OK, I can help you with both, and [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] on one of the.
[AGENT][NEUTRAL] What were the last 4 numbers?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] OK, I have 01.
[CUSTOMER][NEUTRAL] 8829, 1112.
[AGENT][NEUTRAL] OK, that's too many numbers. OK. OK. So what you just said, 018291112, that's too many numbers.
[CUSTOMER][NEUTRAL] MR 7.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well, that's it, that's the number that I have. Hold on one sec.
[CUSTOMER][NEUTRAL] OK, hold on one second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, that's the number I have.
[AGENT][NEUTRAL] You gave me 3 1s.
[CUSTOMER][NEUTRAL] 01829 01829112.
[AGENT][NEUTRAL] Mhm. Yeah.
[CUSTOMER][NEUTRAL] MLA number oh yeah A.
[AGENT][NEUTRAL] OK, you had originally said 3 ones. OK, so one moment, please. And any information that is provided today, [PII] would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is the
[CUSTOMER][NEUTRAL] Date of birth is [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so [PII], again, any information provided will be a verification of benefits and not a guarantee of payment. I do show that he is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] No outpatient.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so on this supplemental policy, the outpatient benefit maximum per calendar day for covered outpatient services is $500 and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Because this is a supplemental policy, [PII], when the claim is submitted to APL for review, we must also receive a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim here we do have a portal that you all should be able to check claim status in and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] OK, uh, another question, do you guys cover procedure up to 2003, 4000?
[CUSTOMER][NEUTRAL] For procedure.
[AGENT][NEUTRAL] Again, this
[AGENT][NEUTRAL] OK, on this supplemental policy, his outpatient benefit maximum per calendar day is $500.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, per day.
[CUSTOMER][NEUTRAL] OK, perfect. Can you give me a reference number for for this call please and your name?
[AGENT][POSITIVE] Yes, ma'am, you would use, you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK, what's your name? Sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, OK, thank you [PII].
[AGENT][POSITIVE] All right. Well, you're welcome, [PII] if that is all I can help you with, and thank you again for calling APL and I hope you have a nice day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye