AccountId: 011433970860
ContactId: d06a8652-ec15-4d3c-858f-124130700d16
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 212220 ms
Total Talk Time (AGENT): 111548 ms
Total Talk Time (CUSTOMER): 41126 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/d06a8652-ec15-4d3c-858f-124130700d16_20250415T17:23_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] More.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 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 need only benefit information. You do not need eligibility as well, is that correct?
[CUSTOMER][POSITIVE] Correct, mhm.
[AGENT][POSITIVE] Yes, ma'am. I can help you with benefits. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] 02258748 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment, [PII], while I get the member's information pulled up, please.
[AGENT][NEUTRAL] And [PII], and the information 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 date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And what type of benefit information do you need on this supplemental policy inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on the supplemental policy, the outpatient benefit maximum per calendar year for covered outpatient services is $1500 per covered insured and there is no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, um, do you know if they've used any of the 1500?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] As of now, no, ma'am, for this calendar year there have not been any benefits used.
[AGENT][NEUTRAL] Now, because this is a supplement, uh-huh, uh, because this is a supplement to the primary insurance when the claim is submitted to APL for review, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL Cassandra, we do have a portal in which you should be able to check claim status.
[AGENT][NEUTRAL] And that portal website is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] OK, and is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] No, if I can just have a call reference number please.
[AGENT][NEUTRAL] You're saying you would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] Perfect thank you so much, [PII].
[AGENT][POSITIVE] Well, you're very welcome and thank you again for calling APL. I hope you have a great afternoon.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Yes ma'am. Thank you.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.