AccountId: 011433970860
ContactId: 0e402f36-6ffc-4d57-91e7-67b9cefe7be8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219970 ms
Total Talk Time (AGENT): 119697 ms
Total Talk Time (CUSTOMER): 49440 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/0e402f36-6ffc-4d57-91e7-67b9cefe7be8_20250509T20:55_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from Nicklas Children's Hospital. Um, I have a patient that has this insurance, and I just wanted to verify that it's active.
[AGENT][NEUTRAL] OK, so you're just needing to verify your eligibility for number, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is it the one that says payer ID?
[AGENT][NEUTRAL] No, ma'am. It, depending on the type of policy they have as to how it's worded, it could have policy certificate, policy number, um, in hospitals, outpatient.
[CUSTOMER][NEUTRAL] OK, outpatient, um, it's 024.
[CUSTOMER][NEUTRAL] 646.
[CUSTOMER][NEUTRAL] 69 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK, thank you, one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. So the policy number you have is not a valid number. Let me give you the correct policy number that you should have.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Just let me know when you're ready.
[CUSTOMER][NEUTRAL] Already.
[AGENT][NEUTRAL] OK, so the correct policy number is 02110932.
[AGENT][NEUTRAL] And this policy, um, she is a dependent on this policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] Excuse me, [PII].
[AGENT][NEUTRAL] And [PII], if you all will be filing a claim for her on this policy, we will also, if there's a way you can make a note of this, we have to have the copy of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] Along with the claim for review and then once the claim has been processed here at APL we do have a portal in which you should be able to check claim status in.
[AGENT][NEUTRAL] And that website for the portal is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Can I get a reference number for the call?
[AGENT][POSITIVE] Uh, yes, ma'am. You will actually use my name along with today's date.
[CUSTOMER][NEUTRAL] OK, what's your name again?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So is there anything else, [PII], that I could help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that's all thank you.
[AGENT][POSITIVE] Alright, well thank you for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you, bye bye.