AccountId: 011433970860
ContactId: e6f9762e-13c9-46d5-8c6b-9542fab31c02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247250 ms
Total Talk Time (AGENT): 120698 ms
Total Talk Time (CUSTOMER): 66003 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/e6f9762e-13c9-46d5-8c6b-9542fab31c02_20250108T15:26_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, how are you? I'm so sorry. What was your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hey [PII], how's it going? My name is [PII].
[AGENT][NEUTRAL] Hi [PII]. How can I help you this morning?
[CUSTOMER][NEUTRAL] I need to verify benefits on this patient um for outpatient surgery at ambulatory surgical center.
[AGENT][NEUTRAL] OK, you're needing outpatient benefits for a member, is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. Do you also need eligibility or strictly benefits?
[CUSTOMER][NEUTRAL] Um, eligibility is fine as well.
[AGENT][POSITIVE] Yes, I can help you with
[CUSTOMER][NEUTRAL] I mean I see on the card it says effective date [PII].
[AGENT][NEUTRAL] OK, yes, I can help you with that though to confirm that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] It is policy, policy, policy.
[CUSTOMER][NEUTRAL] Hm, how a group oh here outpatient benefit certification number. So it's 02573490.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you one.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] Oh, OK. All right, thank you. One moment.
[AGENT][NEUTRAL] And any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. [PII]. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is, bear with me one second, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Oh thank you thank you.
[AGENT][NEUTRAL] OK, so the, um, he is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And the outpatient benefit maximum for covered outpatient services is $1000 for covered person per calendar day.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar day.
[AGENT][NEUTRAL] And because this is a supplemental policy, [PII] to his primary insurance, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] And you may already have this information, but we do have a portal that our claim status can be checked out as well as print the EOBs once the claim has been processed, and that portal website for us is secured. [PII].
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] OK, and is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Can I have a reference number please?
[AGENT][NEUTRAL] Sure, you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] 1825. OK, thank you.
[AGENT][POSITIVE] Yes ma'am. So, well, you're very welcome. So if that's all I can help you with, have a great day and thank you again for calling APL. Yes ma'am.
[CUSTOMER][POSITIVE] Take care.
[CUSTOMER][NEUTRAL] You too. Bye bye.