AccountId: 011433970860
ContactId: 0245496f-6f20-4daf-91df-99f75bfc5fc1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 514489 ms
Total Talk Time (AGENT): 169363 ms
Total Talk Time (CUSTOMER): 112719 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/0245496f-6f20-4daf-91df-99f75bfc5fc1_20250514T20:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] This is [PII] with APL. How can I help you?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Is someone there?
[CUSTOMER][NEUTRAL] Hello, am I audible to you?
[AGENT][NEUTRAL] Oh, can you hear me?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, I can hear you.
[AGENT][NEUTRAL] OK, hi, this is [PII] with APL. How can I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII], calling on behalf of provider office to check on eligibility.
[AGENT][POSITIVE] Sure I can help you with eligibility.
[AGENT][NEUTRAL] Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, sure.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do have the policy number.
[CUSTOMER][NEUTRAL] OK. The policy number.
[CUSTOMER][NEUTRAL] It starts with the number 0194.
[CUSTOMER][NEUTRAL] 749
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK one moment while I look that up for you.
[CUSTOMER][NEUTRAL] Sorry, can you repeat it?
[AGENT][NEUTRAL] Uh, I'm just gonna look that up for you real quick.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the patient's name.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Mhm. I have the date of service.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The data services.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what was the total bill amount? Do you know?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Total bill amount was $571 even.
[AGENT][NEUTRAL] OK. One moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You said it was [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] I'm not showing a claim.
[AGENT][NEUTRAL] For that date of service. However, the effective date for this policy was on
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII] and the policy lapsed in [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I have another policy ID.
[AGENT][NEUTRAL] So let me check something real quick.
[AGENT][NEUTRAL] You have another policy? OK.
[CUSTOMER][POSITIVE] Yes, yes. Sure, sure.
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] No, the member is, the member is same, the policy number is different, so I just need to verify.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And you said you have a different policy number?
[CUSTOMER][NEUTRAL] Yes, for the same member.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's that policy?
[CUSTOMER][NEUTRAL] The policy number is 025.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 852-95.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm showing the effective date for that policy is [PII].
[AGENT][NEUTRAL] And let's see if there's a claim for that data service.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And to verify, it was [PII].
[AGENT][NEUTRAL] Oh, here we go.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I am not showing a claim on file for that date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because uh the claim has not been billed actually.
[AGENT][NEUTRAL] But look.
[AGENT][NEUTRAL] Correct, it looks like we have not received a claim for that. This policy is um still active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And this is a Medlink, so it's a secondary policy. So in order to uh file this claim, we will need the primary EOB or explanation of benefits as well.
[AGENT][NEUTRAL] If the primary will need to um
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The primary will need to uh
[AGENT][NEUTRAL] Accept this claim as well first and then we need to have that claim number or that um EOB afterwards because meddling this particular policy will only pick up if the major medical pays first.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So once they get all of that centered and we do not have timely filing, um, so once we get all, they get all of that in, then they can go to this policy.
[CUSTOMER][NEUTRAL] Mhm. Yes, yes. Sure.
[CUSTOMER][NEUTRAL] OK. Sure. That's all I need.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] And can you provide me the call?
[CUSTOMER][NEUTRAL] Yes, I just need a call reference number for this call.
[AGENT][NEUTRAL] We do not have a call reference number, but you can use my name and the last initial which is [PII] and today's date.
[CUSTOMER][POSITIVE] Today's date. OK. Thank you, [PII], for that help.
[AGENT][POSITIVE] Thank you so much for calling APL with your eligibility. Let me know if you need any further assistance, OK? Have a great day.
[CUSTOMER][NEUTRAL] That's all I need.
[CUSTOMER][POSITIVE] Yes. You too. Thank you so much.
[AGENT][NEUTRAL] Mm bye.
[CUSTOMER][NEUTRAL] Bye.