AccountId: 011433970860
ContactId: 11018595-7d98-48bf-9246-ba0348fed1d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 321250 ms
Total Talk Time (AGENT): 151815 ms
Total Talk Time (CUSTOMER): 64588 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/11018595-7d98-48bf-9246-ba0348fed1d4_20250127T17:38_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, ma'am. This is [PII] I'm calling from provider office. I'm looking for patient eligibility.
[AGENT][NEUTRAL] OK, you're needing eligibility but not benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, I can help you with that. And I'm sorry, did, what did you say your name was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], OK. Yes, [PII], I can help you with [PII]. What is your callback number?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] That is 021-87563.
[AGENT][POSITIVE] Thank you, one moment please.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today 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] Yes. My name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so she had been the subscriber on the supplemental policy, [PII], this policy was effective [PII].
[AGENT][NEUTRAL] And it turned 71-2024.
[AGENT][NEUTRAL] And there is no other active policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know what type of plan HMO like any type?
[AGENT][NEUTRAL] This is, was a, this was a supplemental policy. We are not a major medical insurance.
[CUSTOMER][NEUTRAL] OK, supplemental policy.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How many know the group number do you have?
[AGENT][NEUTRAL] Group number 24825.
[CUSTOMER][NEUTRAL] OK, you are the primary or secondary for this patient?
[AGENT][NEUTRAL] No, sir, we are not a major medical insurance. We would not be a primary. This was a supplemental policy only.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So you are the secondary, right, or not?
[AGENT][NEUTRAL] We were, we were.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, secondly
[AGENT][NEUTRAL] Yes, sir, but this policy again is no longer active as of [PII].
[CUSTOMER][NEUTRAL] OK, ma'am, may I know the electronic pay and mailing address?
[AGENT][NEUTRAL] Payer ID 60801.
[AGENT][NEUTRAL] Claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 8 [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Timely finding limits.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, ma'am, this call reference number.
[AGENT][NEUTRAL] My name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] How to spell your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, ma'am. Thank you. Have a nice day. Bye, ma'am.
[AGENT][NEUTRAL] Well, you're welcome. Yes, [PII], if that's all I can help you with. Thank you again for calling APL and I hope you have a nice day and wait, let me tell you, if you are gonna be, are you going to be filing a claim?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so we, you must also send us a copy of her primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Along with the claim for review and then we have a portal in which you can check claim status and have access to our EOB once we process the claim and our website for our portal is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, ma'am. Thank you.
[AGENT][POSITIVE] You're very welcome and thank you, yes, and have a nice afternoon. Thank you again for calling.
[CUSTOMER][POSITIVE] Thank very much.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, bye bye.