AccountId: 011433970860
ContactId: 14b66df9-4dda-4582-8db3-184ae90094a5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272799 ms
Total Talk Time (AGENT): 153263 ms
Total Talk Time (CUSTOMER): 81016 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/14b66df9-4dda-4582-8db3-184ae90094a5_20250224T20:21_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm trying to verify eligibility for a patient.
[AGENT][NEUTRAL] OK, you're just needing eligibility. You do not need benefit information, is that correct?
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and who am I speaking with please?
[CUSTOMER][NEUTRAL] My name is [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.
[CUSTOMER][NEUTRAL] OK, bear with me one second.
[AGENT][NEUTRAL] Huh.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I have um 02552103.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Oh I don't know.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information, [PII] that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII] [PII].
[AGENT][NEUTRAL] I'm sorry, one more time on the date of birth. I'm sorry, can you?
[CUSTOMER][NEUTRAL] I mean, [PII], it's a lot of 4s.
[AGENT][POSITIVE] OK. A lot of 4s. OK, thank you. All right.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so I do show that he is a dependent on the supplemental policy, and the supplemental policy is active keno with the date of, of excuse, an effective date of [PII].
[CUSTOMER][NEUTRAL] Um, 101 of 24, a supplemental policy is that is this like an insurance?
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] It's a supplemental policy to their primary health care insurance. We're not a major medical carrier.
[CUSTOMER][NEUTRAL] Oh, so they have another primary.
[AGENT][NEUTRAL] Mhm. This is, yes.
[CUSTOMER][NEUTRAL] OK, they have a primary.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And can I have the PO box where the claim should be sent?
[AGENT][NEUTRAL] Yes, it would be PO Box 248,950.
[AGENT][NEUTRAL] Oklahoma City.
[AGENT][NEUTRAL] Oklahoma.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] All right, one more.
[AGENT][NEUTRAL] And if you all will be oh, I'm sorry, do you need me to repeat?
[CUSTOMER][NEUTRAL] No, we just gonna be, I'm sorry, we, we just filed paper claims. I just have one more question. Do you know the name of the other insurance that this type that the patient may have?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] For his employer we show on record America's choice, but we don't have any detailed information on you know their primary.
[AGENT][NEUTRAL] Policy, you would have to contact the member.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] But again it shows America's choice.
[CUSTOMER][NEUTRAL] Yeah, no, that's.
[CUSTOMER][POSITIVE] America's Choice. OK, that's more than fine thank you so much and you have a great day.
[AGENT][NEUTRAL] But it's, yes, ma'am.
[AGENT][NEUTRAL] Well, you're welcome. And just, yeah, [PII], let me give you two additional pieces of information before we get off the line. If you all will be filing a claim with us for this member, we will also have to have a copy of the primary insurance company's explanation of benefits as well when we review a claim. And then once we have processed our claim review.
[AGENT][NEUTRAL] You can, we do have a portal that you should be able to check our claim status in and the website for our portal is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and can I have a reference number for this call?
[AGENT][NEUTRAL] Sure, you would use my name along with today's date.
[CUSTOMER][NEUTRAL] The name again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Crazy, sorry, go crazy.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I see in today's date to [PII].
[AGENT][POSITIVE] That's right.
[CUSTOMER][POSITIVE] OK, thank you so much [PII] you have a great day.
[AGENT][POSITIVE] I hope you have a great day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Oh