AccountId: 011433970860
ContactId: ccf63981-33de-460a-8009-71fe75ab48fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221679 ms
Total Talk Time (AGENT): 125965 ms
Total Talk Time (CUSTOMER): 37920 ms
Interruptions: 1
Overall Sentiment: AGENT=2.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/ccf63981-33de-460a-8009-71fe75ab48fc_20250429T12:11_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, I need to verify benefits for a member.
[AGENT][NEUTRAL] OK. Are you needing only benefits or do you also need eligibility?
[CUSTOMER][NEUTRAL] The eligibility.
[AGENT][POSITIVE] Yes, ma'am. I can help you with both. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] First name is [PII]
[AGENT][POSITIVE] Thank you and [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] 01871735ML8
[AGENT][NEUTRAL] OK, thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the spouse of the subscriber, [PII] on the supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] The of the.
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient, or office?
[CUSTOMER][NEUTRAL] Um, office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this policy, office visits are not covered?
[AGENT][NEUTRAL] However, if she should receive some type of treatment in the office, [PII], that could be reviewed under her outpatient benefit maximum.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that calendar year maximum benefit for covered outpatient services is $1500 with no outpatient deductible.
[CUSTOMER][NEUTRAL] OK dokey, I believe that's all I needed. Can I just get a reference number?
[AGENT][NEUTRAL] Yes ma'am, you would use my name along with today's date, and [PII], should you all end up filing a claim with a PO for her, we will also have to have a copy of her primary insurance company's explanation of benefits along with the claim and then once we have processed our claim here, we do have a portal that you should be able to check claim status in for her by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and can I get the spelling of your first name?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And my name in today's date will be your call reference number.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] All right. Well, you're very welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] That'll be it.
[AGENT][POSITIVE] OK, well then thank you again for calling APO and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.