AccountId: 011433970860
ContactId: 0e934cf9-4cbf-4c6f-8877-df0e1191808d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217660 ms
Total Talk Time (AGENT): 76502 ms
Total Talk Time (CUSTOMER): 109973 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/0e934cf9-4cbf-4c6f-8877-df0e1191808d_20250508T19:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, uh, good afternoon. My name is [PII] and I'm calling from Primary Care Medical Group, and I have one of your subscribers, and I need to ask some questions, especially the eligibility and where do we have to submit the claim.
[AGENT][NEUTRAL] OK, and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. What is the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The policy number.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] D 46401661.
[CUSTOMER][NEUTRAL] Is that the one because it say the medical ID.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, it should say policy certificate or policy er number. um, no worries, give me one moment.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh huh, OK, I see the the number that one.
[AGENT][NEUTRAL] Do do you have a number like that?
[CUSTOMER][NEUTRAL] Yeah, it's 02.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 584,980
[AGENT][POSITIVE] Thank you very much. One moment please.
[AGENT][NEUTRAL] And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is uh [PII].
[CUSTOMER][NEUTRAL] And date of birth is uh [PII].
[AGENT][NEUTRAL] OK, thank you so much, [PII]. You're calling to check eligibility and where to send claims. OK. The member shows effective as of [PII]. This policy shows that it's active for the member.
[AGENT][POSITIVE] And for business, excuse me, and give me one second I'm sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] My apologies, and my apologies, my apologies. OK, thank you for your patience. The claim should be sent to IMA.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 55121.
[CUSTOMER][NEUTRAL] OK and the.
[CUSTOMER][NEUTRAL] Electronic a claim payer ID it's 64556 if I wanna submit it electronic, yeah, and another question, um, we did a sleep study for him. Do we need authorization for him or because I know that it's a PPO.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] This plan does not require any research or pre-authorizations. Actually, none of our policies do.
[CUSTOMER][NEUTRAL] Oh, OK then, then we can submit the claim there. OK, sounds good then, um, I was trying to, to create out that account on on your portal, but when I enter patients, um.
[CUSTOMER][MIXED] In the policy certification number, it doesn't disable oh not found then that's why they couldn't run it over there, OK, but thank you so much.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, well thank you for that. I appreciate that.
[CUSTOMER][NEUTRAL] Uh, no thank you so much for that information. Uh, may I have a reference number just in case?
[AGENT][NEUTRAL] You're welcome. We do not use reference numbers, [PII]. You can use my name [PII] last initial is [PII], and today's date.
[CUSTOMER][POSITIVE] OK dokey thank you so much.
[AGENT][POSITIVE] You're welcome. You too. Thanks for calling APL bye.
[CUSTOMER][POSITIVE] Have a wonderful day.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Bye bye.