AccountId: 011433970860
ContactId: d2b8d339-598c-49fe-9512-e27b7e6a6d0b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184039 ms
Total Talk Time (AGENT): 94892 ms
Total Talk Time (CUSTOMER): 42481 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/d2b8d339-598c-49fe-9512-e27b7e6a6d0b_20250225T21:36_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] Yes, hi [PII], I'm calling because I need to verify benefits for a patient.
[AGENT][NEUTRAL] OK, you're needing to verify benefits for a number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am. Do you also need eligibility or do you already have that?
[CUSTOMER][NEUTRAL] Um, I need eligibility as well.
[AGENT][POSITIVE] Yes, I can help you with both. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the patient's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Um, it is 02580221 ML 8.
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and again, [PII], any information that I do provide would be a verification of benefits and not a guarantee of payment. What is your patient's name and 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 on the supplemental policy, and this supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information are you needing for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Outpatient office visits.
[AGENT][NEUTRAL] OK, office visits are not covered on this policy?
[AGENT][NEUTRAL] She does have an office treatment writer so if there is some form of treatment rendered in the office we could review that under her outpatient benefit max, which is $500 per calendar day for covered outpatient services with no outpatient deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you do end up submitting a claim to us, [PII], for review, we must also have a copy of her primary insurance company's explanation EOB.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] The primary.
[CUSTOMER][NEUTRAL] Yes, I know.
[AGENT][NEUTRAL] And then do you also have our our portal website to check our claim status?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Um, I'm sure it's in the card. Thank you so much for your help. Have a good day.
[AGENT][POSITIVE] You're very welcome. Yes, ma'am, and thank you again for calling APLS that's all I can help you with.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye bye.