AccountId: 011433970860
ContactId: 13b3018a-dd88-4a44-b97f-847741e5a9b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 336769 ms
Total Talk Time (AGENT): 111133 ms
Total Talk Time (CUSTOMER): 171194 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/13b3018a-dd88-4a44-b97f-847741e5a9b7_20250605T13:30_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Try to get to Me. How are you doing today?
[AGENT][NEUTRAL] I'm good, thank you. And can you repeat your name? I didn't get your name.
[CUSTOMER][NEUTRAL] Yeah. My name is [PII].
[AGENT][POSITIVE] OK, thank you, Mr. [PII].
[CUSTOMER][NEUTRAL] And the callback number is [PII], yeah.
[AGENT][NEUTRAL] Hm, OK. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's uh
[CUSTOMER][NEUTRAL] 1372335 M as in Mary L as in Lima number 8.
[AGENT][NEUTRAL] Thank you and you're calling from which facility for annotation?
[CUSTOMER][NEUTRAL] Uh, I'm calling from the provider office by a dermatologist.
[AGENT][NEUTRAL] OK, and you're looking for which information today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, I'm looking for the eligibility for this member.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], sorry, it's [PII].
[CUSTOMER][NEUTRAL] The first name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the last name is [PII]. [PII].
[CUSTOMER][NEUTRAL] And man, man, and man.
[AGENT][NEUTRAL] OK. And may I have the date of birth with the member make sure.
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] OK, thank you. All right. And you said you need eligibility and we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Yeah, actually, the member have.
[CUSTOMER][NEUTRAL] Check the balance because member are spending $145 remaining and the primary is Aetna and to process the claim, and I have to submit the claim to APL now for this member, for the secondary process.
[CUSTOMER][NEUTRAL] That.
[AGENT][NEUTRAL] OK, so you need the address to submit the claim or the fax number or what information are you needing to submit the claim, Mr?
[CUSTOMER][NEUTRAL] Uh, OK. So this member has
[CUSTOMER][NEUTRAL] OK, the member ID number that I
[CUSTOMER][NEUTRAL] Provide you is number active with that?
[AGENT][NEUTRAL] Mhm. Again, the effective date was [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] And I actually, I have here uh on last ML 7 and ML 8. ML 7 is for in hospitals and it's for
[CUSTOMER][NEUTRAL] Out outpatient benefits.
[CUSTOMER][NEUTRAL] The sort number is ML 8 on last. I should use ML 8, right?
[AGENT][NEUTRAL] You don't need to use ML ML7 or ML9 um we just need the numbers in the beginning. It's the same one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, uh, I have to use the ML 7 or 8 or 9.
[AGENT][NEUTRAL] That's optional if you want to use it again, that is optional. Um, if it's an outpatient service, it will be the 8, if it's the inpatient service, it will be the 7.
[CUSTOMER][NEUTRAL] Which should be appropriate.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's a patient office visit, so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And may I have your reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will. Do you need the spelling of my name or any other information, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, can you please spell your first name for me?
[AGENT][NEUTRAL] Sure. That's [PII].
[CUSTOMER][NEUTRAL] OK. Thank you. And the fax number, let me repeat the fax number. OK. The fax number is [PII].
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's what all we live on.
[CUSTOMER][NEUTRAL] On the card. And should I
[CUSTOMER][NEUTRAL] Attach the primary ELB or just send the claim to.
[CUSTOMER][NEUTRAL] The fax
[AGENT][NEUTRAL] OK, we need the primary UB without the primary OB, it will be incomplete. So we need that copy of the primary EOB attached to it.
[CUSTOMER][POSITIVE] Yeah, thank you so much. Have a great day. Take care.
[AGENT][POSITIVE] Yeah, and you as well. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, thank you so much. OK.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good day, Mr. [PII].
[CUSTOMER][NEUTRAL] Yeah.