AccountId: 011433970860
ContactId: f5c94bdc-6872-4947-aee4-03d83278a8b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254949 ms
Total Talk Time (AGENT): 122906 ms
Total Talk Time (CUSTOMER): 56195 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/f5c94bdc-6872-4947-aee4-03d83278a8b2_20250408T15:00_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], uh, first initial of your last name, please?
[AGENT][NEUTRAL] S
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII] in of [PII]. How are you today?
[AGENT][NEUTRAL] I'm fine. You said your name is [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and [PII], your first initial to your last name?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And how can I help you today?
[CUSTOMER][NEUTRAL] I'm calling in reference to a patient that's scheduled for outpatient procedure. Just wanted to confirm if they're still active with APL, and if they are, uh, how much would, um, they cover for the deductible for outpatient procedure?
[AGENT][NEUTRAL] OK, so you're needing to get eligibility and outpatient benefits, is that correct, [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And what is the callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] It is 02301189 M as in Mike, L as in Lima, 8.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments please, [PII] to get the member's information pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then, oh, you're certainly welcome, and any information that I do provide 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] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is a subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And she has an outpatient benefit maximum per calendar year for covered outpatient services of $2500 and there is no outpatient deductible per covered person per calendar year.
[CUSTOMER][NEUTRAL] Has she um used any of it?
[AGENT][NEUTRAL] I can check that for you, just a moment.
[AGENT][NEUTRAL] As of now, she has used $977.16.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] For this calendar year.
[CUSTOMER][POSITIVE] Perfect. Do you provide reference number for the call?
[AGENT][NEUTRAL] Yes, ma'am, and just a, yes ma'am, and just a couple of additional things. First off, [PII], uh, because it is a supplemental policy when the claim is submitted to APL for review, we will also have to have a copy for primary insurance company's explanation of benefits as well. And then once we have processed our claim here, we have our portal at [PII] in which you should be able to check claim status.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For the reference number you're gonna use my name along with today's date. You're welcome.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][POSITIVE] And is there anything else I can help you with? Oh, well, thank you. I hope you have a great day as well and thank you again. OK. Thank you for calling ABL. Bye-bye.
[CUSTOMER][POSITIVE] Have a great day. Bye.
[CUSTOMER][POSITIVE] No, that's it. Thank you. Bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.