AccountId: 011433970860
ContactId: 1717efc1-093f-4ab6-a59e-2625f54b7224
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 455690 ms
Total Talk Time (AGENT): 183890 ms
Total Talk Time (CUSTOMER): 124305 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/1717efc1-093f-4ab6-a59e-2625f54b7224_20250423T20:54_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is yeah. I'm calling from facility.
[AGENT][NEUTRAL] Hi, I didn't catch your name. It went in and out. Can you repeat that, please?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from facility.
[AGENT][NEUTRAL] Hi, [PII], and how may I assist you today?
[CUSTOMER][NEUTRAL] I need eligibility and benefits and prior authorization.
[CUSTOMER][NEUTRAL] Could you please help me with that?
[AGENT][NEUTRAL] You want to go over benefits and authorization?
[CUSTOMER][NEUTRAL] Yeah, eligibility and benefits and authorization.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the eligibility benefits and authorization. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Member ID is 684284659.
[AGENT][NEUTRAL] OK, it's, did you say 684-284-659?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, do you have a copy of their ID card available?
[CUSTOMER][NEUTRAL] Yeah, I have that.
[AGENT][NEUTRAL] And on the ID card, do you see anywhere that says outpatient or inpatient policy cert number?
[CUSTOMER][NEUTRAL] Inpatient ambulatory surgery in network.
[AGENT][NEUTRAL] On the card, do you see anywhere that says inpatient policy certification number? It may start with a 01 or 02.
[CUSTOMER][NEGATIVE] I don't want the number.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Do you have the full social for the patient?
[CUSTOMER][NEUTRAL] Which, sorry, could you please do it ahead?
[AGENT][NEUTRAL] Sure, so the the number that you provided is not an APL policy number, so I'm just trying to see what else I can use to locate the policy. Do you have the member's full social security number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I have that. Just a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Social Security, the last number is [PII].
[AGENT][NEUTRAL] I will need the full social.
[CUSTOMER][NEUTRAL] Yeah, just four num last four digit number, [PII]. I have only last four digits.
[AGENT][NEUTRAL] OK, sir, are you saying all you have is the last 4? OK, what's the member's first and last name?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII].
[AGENT][NEUTRAL] Last name is
[CUSTOMER][NEUTRAL] Sorry. Last name is [PII], first name is [PII].
[AGENT][NEUTRAL] Can you spell the first name for me, please?
[CUSTOMER][NEUTRAL] Yeah, first name is [PII] Yuck.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] [PII], what was the last letter?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] So the first name is [PII]. Was there another letter after the [PII]?
[CUSTOMER][NEUTRAL] No, [PII] after that Y. Yo.
[AGENT][NEUTRAL] Why? OK. Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment, I'm just trying to locate the policy for you.
[CUSTOMER][NEUTRAL] Yeah, OK, sure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, so I tried.
[AGENT][NEUTRAL] Cooper Dempsey, and then I tried Dempsey Cooper, but there's no policy that came up um with that name.
[AGENT][NEUTRAL] We don't have the full social and it looks like that.
[AGENT][NEUTRAL] The [PII] number could be Business Workers of America, but we can't use that in our system. Um, so we would need more information to search for the member.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] But I have this one. Could you please, uh, Dempsey B. Cooper?
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] There's no Dempsey Cooper or Cooper Dempsey in our system. I searched it both ways.
[AGENT][NEUTRAL] The only way that we can
[CUSTOMER][NEUTRAL] But I have only this.
[AGENT][NEUTRAL] Right, so the only way that we can search for a policy is the first and last name, the full social, or their policy number. We don't have the full social or the policy number and nothing is coming up with the name. So we're going to need more information. So you'll have to reach out to the member and either get the the um policy number or the full social, something else that we can try to search with. We don't have enough information.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, OK, just a minute.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][POSITIVE] Yeah. OK. Thank you so much for your great information. You cannot pull this patient, right?
[AGENT][NEUTRAL] Right, we don't have enough information to search for a policy. We would need either the policy number or the social, the full social security number, um, because nothing is coming up with the first and last name.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, OK, no issues. OK. Thank you so much for your great information. Could you please tell me your name and call reference number?
[AGENT][NEUTRAL] Yes, so my name is [PII] The first initial to my last name is [PII], and there's no call reference number, but you can use my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, OK. Thank you so much, for now. Bye-bye.
[AGENT][POSITIVE] You're welcome [PII]. Was there anything else I can help with?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] OK