AccountId: 011433970860
ContactId: e2bfe8ee-0c89-476f-9bb6-5aeb0575eb3e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316190 ms
Total Talk Time (AGENT): 139817 ms
Total Talk Time (CUSTOMER): 98542 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/e2bfe8ee-0c89-476f-9bb6-5aeb0575eb3e_20250409T20:36_UTC.wav
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[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is Ay[PII]How can I help you?
[CUSTOMER][NEUTRAL] Be[PII]Hi, my name is Ro[PII]nd I was calling.
[AGENT][NEUTRAL] No, my name is Tr[PII].
[CUSTOMER][NEUTRAL] Oh Tr[PII]OK, I'm sorry. I'm calling from, uh, de[PII]or medical benefits on a patient.
[AGENT][NEUTRAL] OK, you're needing to check benefits. Do you also need eligibility or just benefit?
[CUSTOMER][NEUTRAL] Eligibility and benefits both.
[AGENT][NEUTRAL] Information.
[AGENT][NEUTRAL] Yes, ma'am. I can help with that. And you say is Ro[PII]is that correct?
[CUSTOMER][NEUTRAL] Probation.
[CUSTOMER][NEUTRAL] Yeah, R.
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] [PII]h, OK. OK, Ro[PII]thank you. And what is your callback number?
[CUSTOMER][NEUTRAL] 30[PII].
[CUSTOMER][NEUTRAL] 44[PII]
[AGENT][NEUTRAL] [PII]hm.
[AGENT][POSITIVE] Thank you and
[AGENT][NEUTRAL] Ro[PII]what is the member's policy number?
[CUSTOMER][NEUTRAL] It's um.
[CUSTOMER][NEUTRAL] 02 R. 02543.
[AGENT][NEUTRAL] OK. OK, so that's not gonna be an R. It's, what, OK, so it's 02.
[CUSTOMER][NEUTRAL] Well, try this one because when I called they gave me that number but they gave me like two different numbers because he changed his ID and when I called last month they gave me this other number 02[PII].
[AGENT][NEUTRAL] Then that should be a number.
[AGENT][NEUTRAL] Thank you one moment and again you're needing eligibility and benefits, correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, for me, OK, I can help you with that. All right, and so any information that's provided 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] Pa[PII]6[PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, said that he is a subscriber on the supplemental policy Ro[PII]This policy is active and the effective date on the plan is 11[PII].
[AGENT][NEUTRAL] And the 02502543 is the correct policy number.
[CUSTOMER][NEUTRAL] 02502543 you said?
[AGENT][POSITIVE] Yes, ma'am. That is correct. Uh-huh.
[CUSTOMER][NEUTRAL] OK, thank you and um so um last time I called they told me that the insurance covers.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And again, it is active. You're welcome.
[CUSTOMER][NEUTRAL] Yeah, uh, last time I called they told me that the insurance covers up to 2500 calendar year. I wanna know they're still available because he's coming in tomorrow for an MRI.
[AGENT][NEUTRAL] Mm, go ahead.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. I, so you're wanting to verify what is, has been used for this calendar year, is that correct?
[CUSTOMER][NEUTRAL] Yes, he's coming in tomorrow for an MRI um we already got the approval from the primary insurance and the verification as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so as of now he has not used any of his calendar year benefits for outpatient as of now.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you so much for helping me out. Any reference call number because I always need to ask for one.
[AGENT][POSITIVE] Yes. You're welcome.
[AGENT][NEUTRAL] Yes, ma'am. You will, that's fine, but I need to give you a couple more pieces of information, Re[PII]I don't know if the person you spoke to before told you this, but 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 as well.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then once
[CUSTOMER][NEGATIVE] Yeah, my billing company no.
[AGENT][NEUTRAL] OK, and once we process our claim, claim status should be able to be checked in our portal by going to secured. Am[PII]As for your reference number, you will use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you for helping me out thank you.
[AGENT][POSITIVE] You're welcome. Yes, ma'am. And can I help you with anything else?
[CUSTOMER][POSITIVE] That'll be appreciated thanks bye bye.
[AGENT][POSITIVE] OK. You're welcome and have a nice evening. Thank you again for calling APL.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye-bye.