AccountId: 011433970860
ContactId: 159a77de-ed4d-4546-b3d0-b223619a3c3e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314950 ms
Total Talk Time (AGENT): 74800 ms
Total Talk Time (CUSTOMER): 185861 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/159a77de-ed4d-4546-b3d0-b223619a3c3e_20250218T13:20_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from provider's office regarding member eligibility.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure. Callback number will be [PII] [PII]. And uh you also need the policy number, right?
[AGENT][POSITIVE] Yes, that is correct, [PII].
[CUSTOMER][NEUTRAL] It's 02.
[CUSTOMER][NEUTRAL] 255682 M as in Mike, L as in Lima, E as in Echo.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's full name is [PII] with the date of birth [PII].
[AGENT][NEUTRAL] And you're calling to verify eligibility for what place of service?
[CUSTOMER][NEUTRAL] For, uh, it's for the facility and the facility's name is Baptist Hospital of Miami.
[AGENT][NEUTRAL] This member has outpatient benefits of $1000 per calendar year and this is not a guaranteed benefit just a disclaimer of the policy's coverage. This policy has been active since [PII] and it's currently active.
[CUSTOMER][POSITIVE] Thank you so much for that. And uh uh could you please provide me with the member's group number or group ID?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure, give me one moment.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] The group number is 26 um the group number is 256-68 that's 25668.
[CUSTOMER][POSITIVE] Thank you so much for that. And it's a secondary gap policy, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for the confirmation, [PII]. And the thing is, uh, I do have uh one more question for you regarding this member plan. May I know whether the member correct is a subscriber or a dependent in the plan?
[AGENT][NEUTRAL] He's the subscriber.
[CUSTOMER][POSITIVE] Thank you so much for the confirmation. And [PII], the thing is I do have 2 more to check for eligibility. Could you please also help me with them?
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] For the next member, I have the policy number as 81.
[CUSTOMER][NEUTRAL] 09
[CUSTOMER][NEUTRAL] 0943200.
[AGENT][NEUTRAL] That's not a policy number, that's too long. Could you verify the policy number if you have a copy of the card? Because that's not a policy number here at American Public Life.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Unfortunately, sir, I don't have access to member's uh card copy, but if you could, uh, please search with members first name and last name.
[AGENT][NEUTRAL] Do you have the member's social?
[CUSTOMER][NEUTRAL] Yeah. Uh, one moment. I need to get that for you. Just give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, uh, unfortunately, I don't have the full social for the number. Just give me a moment. I need to check in another file.
[CUSTOMER][NEUTRAL] I'm sorry for the child. I don't have the member's SSN number.
[AGENT][NEUTRAL] What is the member's last name?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Member's last name is [PII].
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] I'm not showing the memory in the, the system with the name.
[CUSTOMER][POSITIVE] Sure. Uh, no problem. Thank you so much for that, [PII]. And shall I provide the last members?
[CUSTOMER][NEUTRAL] Oh, details, uh, for this number.
[AGENT][NEUTRAL] Yes, what is the policy number?
[CUSTOMER][NEUTRAL] Uh, actually, for this number, I don't have his, uh, uh, correct policy number. One moment, let me see. I have the member's social security number.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, I have the decision for the member. Shall I provide that?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What is this member's name?
[CUSTOMER][NEUTRAL] Member first name, it's [PII] and the last name it's [PII].
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Spell the first name again for me.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Last name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] I'm not finding that name in the system either.
[CUSTOMER][POSITIVE] OK, no problem. Thank you so much for that, [PII]. And uh uh the call reference number will be your name on today's date, right?
[AGENT][NEUTRAL] We don't provide reference numbers. Yes, that's correct, [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you so much for that, [PII]. Have a great day and stay safe.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well. Goodbye.
[CUSTOMER][POSITIVE] Thank you. Bye.