AccountId: 011433970860
ContactId: 15de5dd4-971a-4e15-aee2-70563c8be6cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242009 ms
Total Talk Time (AGENT): 125688 ms
Total Talk Time (CUSTOMER): 99197 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/15de5dd4-971a-4e15-aee2-70563c8be6cb_20250113T20:49_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] Hello, Ms. [PII]. My name is [PII]. I'm calling from the provider's office. Um, I was calling to confirm if a patient's plan was active.
[AGENT][NEUTRAL] OK, you're needing to verify eligibility only for a member, not benefits. Is that correct?
[CUSTOMER][NEUTRAL] Uh, yes, I just wanted to know if it was um an an active plan.
[AGENT][NEUTRAL] Yes, ma'am. I can help you with that. And um could you please spell your first name for me? I didn't.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] [PII]. OK, thank you. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] See 60801.
[AGENT][NEUTRAL] That's our payer ID number.
[CUSTOMER][NEUTRAL] Oh, OK, let me check oh yeah payer ID.
[CUSTOMER][NEUTRAL] OK, let me see, outpatient benefit certification number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] OK. 0233708, M like Mary, L like Lima, number 8.
[AGENT][NEUTRAL] OK, get, um, what was that number one more time? I think I either missed a number or, or, or we just missed a number. I'm not sure which one it was.
[CUSTOMER][NEUTRAL] OK, no problem. Let me, let me start from the beginning. So I have 02337082 letter M like [PII], L like Lima number 8.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. It was the 2 that was after the 8 that I missed the first time. OK, thank you. One moment, please.
[AGENT][NEUTRAL] And so 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, please, and your date of birth?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII]. Date of birth, let me see, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] do that too.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] So I do show that she is the spouse of the subscriber on the supplemental policy, and this supplemental policy is active with an effective date of [PII]. And so because this is a supplement to the primary insurance, we will have to have a copy of the primary insurance company's explanation of benefits along with any claim for review.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And then also once the claim has been processed with APL we do have a portal that you can check claim status and also have access to the EOBs.
[AGENT][NEUTRAL] And that website for our portal is [PII].
[CUSTOMER][NEUTRAL] in March
[CUSTOMER][NEUTRAL] She came for evaluation.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, ma'am, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you for letting me know yeah I'll definitely set up an account.
[AGENT][POSITIVE] Absolutely. Well, you're very welcome. So is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, yes, may I have a reference number for the call?
[AGENT][POSITIVE] Yes ma'am, you'll actually use my name along with today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, may I have your name again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you for your help, Ms. [PII]. You have a good day.
[AGENT][POSITIVE] OK. Well, you, absolutely. You're very welcome. And thank you again for calling APL. I hope you have a nice day as well.