AccountId: 011433970860
ContactId: e7bd768c-dd47-4cc0-8031-1dcd430f933f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291260 ms
Total Talk Time (AGENT): 137233 ms
Total Talk Time (CUSTOMER): 120134 ms
Interruptions: 2
Overall Sentiment: AGENT=2.2, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/e7bd768c-dd47-4cc0-8031-1dcd430f933f_20250505T20:00_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], can I verify.
[AGENT][NEUTRAL] I'm so sorry. I can barely hear you.
[CUSTOMER][NEUTRAL] Uh, give me one second, maybe my mic on.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, yeah, hold on, hold on, it's coming. How's that?
[AGENT][POSITIVE] That's much better.
[CUSTOMER][NEUTRAL] [PII] there?
[CUSTOMER][NEUTRAL] Alright, yeah, my system knocked out just now.
[AGENT][NEUTRAL] Yes, that's, I can hear you.
[AGENT][POSITIVE] Oh, goodness.
[CUSTOMER][NEUTRAL] So I'm trying to verify, see, it, it happened these mics. I'm trying to verify, uh, eligibility and benefits for a member to see if, uh, for his looks like a gap plan he has here, American Pub Life, yeah, mhm.
[AGENT][NEUTRAL] OK, alright, so you're needing eligibility and benefits for a member, is that correct?
[CUSTOMER][POSITIVE] That's correct, [PII] thank you so much appreciate it.
[AGENT][POSITIVE] Yes, I can, yeah, sure, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Uh, I'm [PII]
[AGENT][NEUTRAL] OK, thank you. And from what is your callback number please?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, let's see, 255-6501.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments please to get the member's information pulled up.
[CUSTOMER][POSITIVE] Sure, sounds great. See, mhm, you as well see.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And any information of 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] Uh, [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thanks, [PII].
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And this will be for outpatient hospital facility benefits we're looking for coverage as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so yes, he is a subscriber on the supplemental policy FM and it is active with an effective date of [PII].
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And you said it's outpatient, OK, his outpatient benefit maximum per calendar year for covered outpatient services is $8700 and there is no outpatient deductible. I can check that for you just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Anything used?
[CUSTOMER][POSITIVE] OK perfect thanks [PII] no doubt perfect perfect perfect excellent.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Sounds good so far let's see.
[AGENT][NEUTRAL] And as of now he has used $210.
[CUSTOMER][POSITIVE] OK wonderful. $210 alright great and lastly, can I get a thank you uh huh go ahead you saying.
[AGENT][POSITIVE] That is correct, yes, now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh yes, I was gonna say, um, when the claim is submitted to us for review, we will have to have a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim here we do have a portal that you should be able to check our claim status in and the portal is located at secured.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK perfect thank you so much appreciate it again.
[AGENT][NEUTRAL] OK. And again, you will use my name and today's date as a reference number.
[CUSTOMER][NEUTRAL] And then [PII] uh sorry mhm.
[CUSTOMER][POSITIVE] Perfect. You read my, you read my mind. Awesome. OK. Is it, is it, is it [PII] or I, I'm not sure which one.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] No, [PII]
[CUSTOMER][POSITIVE] Uh, I should have got my first instinct, [PII] I. [PII] Awesome.
[AGENT][NEUTRAL] Oh, that's what they say, you always get your gut instinct. So if that I was first, yeah, you should have gone there.
[CUSTOMER][NEUTRAL] That's why
[CUSTOMER][NEUTRAL] I, I should have got it. I should have. I was a nerd. I should have gone with it, my bad. And just a date, right? That's good enough.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes. My name and today's date. That's correct.
[CUSTOMER][NEUTRAL] You've been bro.
[CUSTOMER][POSITIVE] Thank thanks [PII] you've been awesome. I appreciate all your help today.
[AGENT][POSITIVE] Oh, well, you're certainly welcome, Era. So if that's all I can help you with, thank you again for calling APL and I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Likewise you too take care now bye bye now.
[AGENT][POSITIVE] Thank you. You too. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.