AccountId: 011433970860
ContactId: e0ccf49e-ace6-47f7-9a1d-3f45c3783fc4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227860 ms
Total Talk Time (AGENT): 111359 ms
Total Talk Time (CUSTOMER): 64357 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/2025/01/29/e0ccf49e-ace6-47f7-9a1d-3f45c3783fc4_20250129T18:21_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you so much, [PII]. My name is [PII]. I'm calling from Baptist Cancer Institute, and I'm just calling to verify if this patient's policy is still active.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], so you're just needing to verify eligibility for a member, is that correct?
[CUSTOMER][POSITIVE] Yes, ma'am, that is correct.
[AGENT][NEUTRAL] Yes, OK, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is the patient's policy number, please?
[CUSTOMER][NEUTRAL] It's 24567002.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so any information [PII] that I do provide for you today 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] Yes.
[CUSTOMER][NEUTRAL] Her name is [PII] and her date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so I do show that she is the subscriber on the supplemental policy, [PII]. It is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you all will be filing claims with APL, we will also have to have a copy of the primary insurance company's explanation of benefits for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then also, so once we have processed our claim.
[AGENT][NEUTRAL] We do have a portal that you should be able to check claim status and have access to the EOBs or APL by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Uh, um, yes. Is, uh, there like an out of pocket, um, um,
[CUSTOMER][NEUTRAL] Expense or um for the supplemental plan if they used it, if they've used any of the benefits.
[AGENT][NEUTRAL] So you also need benefit information?
[CUSTOMER][NEUTRAL] Yes, please. Mhm.
[AGENT][NEUTRAL] I'm sorry, I misunderstood you. I thought you only needed eligibility. OK, one second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So her outpatient benefit max.
[AGENT][NEUTRAL] It's $6000 per calendar year for covered outpatient services and there's no outpatient deductible for covered person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] And just one moment, um.
[AGENT][NEGATIVE] And as of now for this calendar year, there have not been any benefits used.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much, Ms. [PII]. Will there be a reference number for this call?
[AGENT][POSITIVE] You, you are very welcome.
[AGENT][NEUTRAL] Yes, ma'am. You would use my name along with today's date.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. I do appreciate your time.
[AGENT][POSITIVE] OK. Well, yes, ma'am. You're very welcome and thank you again for calling out of APO. I hope you have a great afternoon.
[CUSTOMER][NEUTRAL] Likewise. Bye-bye