AccountId: 011433970860
ContactId: dbe1f0a3-fc12-4cbf-bc2f-863f47015677
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271049 ms
Total Talk Time (AGENT): 118075 ms
Total Talk Time (CUSTOMER): 36421 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/dbe1f0a3-fc12-4cbf-bc2f-863f47015677_20250116T14:04_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 [PII], I was calling for benefits please.
[AGENT][NEUTRAL] OK, you're needing benefit information for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] I'm sorry, [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's oh, OK, I'm sorry. Option 4, OK, and the member's policy number, please.
[CUSTOMER][NEUTRAL] Option 4.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 02253299
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] Just one moment, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you did say you were needing eligibility and outpatient benefits?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and any information that I do provide will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] The name is [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is the subscriber on this supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And she has an outpatient.
[AGENT][NEUTRAL] Um, give me, give me just one second. I'm sorry.
[AGENT][NEUTRAL] Uh, if the benefits are still lighting, so just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so on this policy, she has her maximum outpatient benefits for covered outpatient services is $500 per covered person per occurrence and there is no outpatient deductible per covered person per occurrence.
[CUSTOMER][NEUTRAL] So $500 per occurrence.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we will also have to have a copy of the primary insurance company's explanation of benefits [PII] along with our claim for review.
[AGENT][NEUTRAL] And then once the claim has been processed by APO we do have a portal in which you can check claim status, and that portal for us is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] And can I have a reference number please?
[AGENT][NEUTRAL] Sure, you would use my name along with today's date.
[CUSTOMER][POSITIVE] OK great thank you [PII] have a good day.
[AGENT][POSITIVE] Well, you are certainly welcome, [PII]. Yes, ma'am, you too. And if that's all that I can help you with, thank you again for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.