AccountId: 011433970860
ContactId: d28838a5-c2b2-4460-b924-b5cfd6e87fed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202360 ms
Total Talk Time (AGENT): 123292 ms
Total Talk Time (CUSTOMER): 48175 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/d28838a5-c2b2-4460-b924-b5cfd6e87fed_20250403T17:57_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] from [PII] Diagnose thee machine. I need to verify a benefit for a patient that's here right now. Thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Uh, you said your name is [PII], is that correct?
[CUSTOMER][NEUTRAL] [PII]. Correct.
[AGENT][NEUTRAL] OK, yes, and and you're needing to verify eligibility and benefits or only benefits?
[CUSTOMER][POSITIVE] Yes, both please.
[AGENT][POSITIVE] Both. OK, yes, ma'am. I can help you with both. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the members.
[CUSTOMER][NEUTRAL] The red line.
[AGENT][NEUTRAL] And the member's policy number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. 01637396 ML 8.
[AGENT][NEUTRAL] OK thank you one moment while I get that member's information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And [PII], any information that I provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the spouse of a subscriber on the supplemental policy, and the supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefit information do you need inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient for an MRI mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So she has an outpatient benefit maximum of $1000.
[AGENT][NEUTRAL] Per calendar day.
[AGENT][NEUTRAL] For covered outpatient services and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] And because this is a supplemental policy, Anita to her primary insurance when the, when you all file your claim with APL, we will need to also receive a copy of her primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim here we do have a portal that you should be able to check our claim status in by going to secured. [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right perfect thank you um.
[AGENT][POSITIVE] All right. You're welcome. And can I help you with anything else?
[CUSTOMER][NEUTRAL] No, that will be all. I just need a reference number.
[AGENT][NEUTRAL] OK, you will use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] And what's the the um your first letter, [PII], the last name?
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] All right thank you I appreciate your help.
[AGENT][POSITIVE] All right, well, you're certainly very welcome. So again, if that's all I can help you with, thank you for calling APL today and I hope you have a great rest of your day, [PII].
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Uh-huh, thank