AccountId: 011433970860
ContactId: 0a7186e6-ebe6-4175-a5ee-7bfe6883d134
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 667159 ms
Total Talk Time (AGENT): 314788 ms
Total Talk Time (CUSTOMER): 354278 ms
Interruptions: 8
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/0a7186e6-ebe6-4175-a5ee-7bfe6883d134_20250224T15:13_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, good morning. My name is [PII]. I'm calling from admissions office at Grainger Bloomsburg Hospital in [PII], and, um, excuse me, I'm trying to verify, uh, eligibility for one of our patients.
[AGENT][NEUTRAL] Sure, I can assist you with eligibility and Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, it's, it's a very fuzzy image of the card that they scanned, but I think it's 943302256.
[AGENT][NEUTRAL] Mm. OK, that's not our number.
[CUSTOMER][NEGATIVE] That's for [PII]'s, it's not.
[AGENT][NEUTRAL] No, uh uh.
[CUSTOMER][NEUTRAL] Well, the, the hold on one second, let me just.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Is the name on the card APL?
[CUSTOMER][NEUTRAL] Uh, hold on one second, let me go back to it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, this is what they, it's.
[CUSTOMER][NEUTRAL] It's, I think it's a it's well it's there's so many things on this card. It is Oxford, there's multi-plan medical.
[CUSTOMER][NEUTRAL] Um, and it says for.
[CUSTOMER][NEUTRAL] Um, I can't make out any phone numbers, so I called the number that they put on electronically like we have electronic file of the insurance and then they put, we can scan the card, so whoever typed the number that's the one I called but um.
[CUSTOMER][NEUTRAL] There's a multi-plan logo on the card, but also it says Oxford.
[CUSTOMER][NEUTRAL] Member on the back it says for medical claims, medical benefits, it says um 90 degree health.
[CUSTOMER][NEUTRAL] [PII] address it says benefits.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, it sounds like it's an IMA card. Um, no, um, not sure if O for is gonna be the, the main, um, doesn't sound like it's with us. I can do a name search or if you have a social, I can do a social um check, sorry I search and see. OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, let me give you that. Um, yeah, hold on one second. So, social would be, I hope they have it in here, yeah. It's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] And that's for uh [PII].
[CUSTOMER][NEUTRAL] [PII] is the birthday.
[AGENT][NEUTRAL] OK, so we do have um, alright, so let me just go ahead and
[AGENT][NEGATIVE] Misinformation and.
[CUSTOMER][NEUTRAL] So I just so the phone number I called is that that's a provider line or [PII], right?
[AGENT][NEUTRAL] Mm, no, that's not ours, but um let me see what, what, what did you call exactly?
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] You said the [PII] was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I don't see that one anymore, OK, um.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] But I did find a policy. What type of service is being rendered?
[CUSTOMER][NEUTRAL] I mean it's
[CUSTOMER][NEUTRAL] So he's here for inpatient admission.
[AGENT][NEUTRAL] Submission. OK, so I did find a policy. It is a limited policy and this is for admission for hospitalization. I can give you the information of our, uh, policy that we have for this member. I'm not sure if he has any other policies, but yeah, uh, I did find him in our system, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, thank goodness. OK. What is his actual ID then?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, and the policy number we have here for this member is 0257.
[AGENT][NEUTRAL] 2295.
[CUSTOMER][NEUTRAL] 95, you know what, let me see something. There was another card that he gave.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so this, this is interesting because the they have two multi plans in here and the one, the card that I had, it said multiplan also, but when I called the number, it said pharmacy benefits and it looks like not maybe he has two cards, but that is the ID that I have on here [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII]. So I, I didn't give you this one because on the card it literally has nothing except it says it's a pharmacy benefits. So I would, would he have two cards, one for medical coverage, one for.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] One for uh prescription or no?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh well, he has um two cards. One is gonna come directly from IMA or from um benefits in a card, which is the one that he get he got this insurance through.
[AGENT][NEUTRAL] And he's gonna have a lot of numbers which is probably the one you've seen, and then he's gonna get one from us directly, which is probably the other one you're seeing. And the one from us it should say hospital indemnity and it's gonna have the information of the pharmacy in the back of the card. So I don't know if he just probably, uh, or probably you have just a scan of the back and it shows just the information for the uh pharmacy, but the front should um should tell you that it's a hospital indemnity plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so let me see, the front says APL American Public Life.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So that is his medical coverage, but there is no phone number on the front except the phone number that says to locate the provider and so when I go, yeah, when I looked in the back it said customer service and then it it says for pharmacy so there was no phone phone it seemed for anything other than the pharmacy that's why I got confused so I apologize. So the phone number on the.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] In the back. Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, that's OK.
[CUSTOMER][NEUTRAL] The what would be the phone number to call so I should document this to call if somebody wanted to verify specifically medical benefits.
[AGENT][NEUTRAL] Medical benefits is us, so it's going to be [PII].
[AGENT][NEUTRAL] I'm sorry, that's the fax number. That's, I do apologize. I'm giving you the fax number.
[CUSTOMER][NEUTRAL] [PII]. That's OK, mhm.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] I'm looking at too many numbers. Give me just a second.
[AGENT][NEGATIVE] Yeah, it went off my head. OK.
[AGENT][NEUTRAL] 18, no, I know it's 1870 OK let me just get my head back in the game um.
[AGENT][NEUTRAL] And that one.
[CUSTOMER][POSITIVE] I'm glad I'm not the only one that's having a crazy day. I feel like everything just.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] That's that's.
[AGENT][NEUTRAL] Yeah, no, especially with this type of product, yeah, it's, it's just a lot of information and then, um, it, it's just a lot of information.
[AGENT][NEUTRAL] I understand it's OK. Uh, let's see, um, OK, so it is going to be.
[AGENT][NEUTRAL] 1800256-8606.
[CUSTOMER][NEUTRAL] 8606. OK, so 25,680 8606. All right. Let me cross out all these other ones. OK. So, and then the ID was
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, the other one do not cross it.
[AGENT][NEUTRAL] Because the other one is IMA.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And let me explain this because it's a little bit you're gonna need that other one as well.
[CUSTOMER][NEUTRAL] Right, the other one is.
[CUSTOMER][NEUTRAL] Are you saying the other one I do need it for, for what?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For a claim status.
[CUSTOMER][NEUTRAL] Oh, for claims that, well, they can, we, we here it's a different department so they can, I'm not, I'm just gonna leave the one for eligibility is gonna be where we go. All right, as long as I have at least that, um, so for, can you give me an idea? It's a limited benefit hospital, so this, I'm assuming because it says hospital indemnity, so this will cover hospital stay. Is there extra information you can provide like how much it covers or is there co-insurance?
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Is a different department? OK, perfect then, yeah, OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It was.
[AGENT][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] Yes. Mhm. Yes, let me give you this information before I give you any benefit information, you're welcome. I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. Um, and again, this is a limited policy. So with this policy, uh, we cover admission, the admission is going to be 1500.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is, um, looks like 4 times per year. Let me double check.
[AGENT][NEUTRAL] yeah.
[CUSTOMER][NEUTRAL] So total benefits would be 1500.
[AGENT][NEUTRAL] Yeah, the, that's just for admission. And then you have a daily hospital confinement of $100 daily. So it's gonna be $1500 100 dollars daily.
[CUSTOMER][NEUTRAL] $100 toward each day of admission.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] Each day of admission, that's, that's being paid by insurance.
[AGENT][NEUTRAL] Correct, that is the amount that we're gonna cover, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, and let's see, I guess that's all I needed and for uh for this conversation, could you provide a call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Um, do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] If you don't mind, I will take that spelling if you don't.
[AGENT][NEUTRAL] For sure. No problem. Yes. That's [PII].
[CUSTOMER][NEUTRAL] Um, OK, thank you so much. I appreciate your help today and sorry for the confusion. I just, like I said, I, I called that number twice because I thought maybe I missed out, but then it did say that it's pharmacy, so I'm like, OK, but what number, um, because I think what I'm looking at, the more I look at this card, I think that there has to, there is a number to call, but it's cut off at the top. So that's probably what happened. So it looks like there's something on the very top that may have been where that number is.
[AGENT][NEUTRAL] You, no, it's fine.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] So thank you so much for your help and I hope you have a good rest of the day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You as Miss [PII], and thank you for calling APL. Have a good week. Bye-bye. You're welcome. Bye.
[CUSTOMER][POSITIVE] Thank you. Thank you. You too. Bye-bye.