AccountId: 011433970860
ContactId: 2011903e-cf0a-41b6-8ac7-238d05bb0afb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 255449 ms
Total Talk Time (AGENT): 134187 ms
Total Talk Time (CUSTOMER): 75524 ms
Interruptions: 3
Overall Sentiment: AGENT=1.7, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/2011903e-cf0a-41b6-8ac7-238d05bb0afb_20250326T14:48_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm with Saint Francis Coordination and benefits department, and I'm calling to verify that coverage is active for a patient and to see if you require coordination of benefits. I do need to let you know the entire call is monitored and recorded for quality and compliance purposes.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, [PII], so you're wanting to find out, that's fine, and you're wanting to find out if the policy is active. Is that correct? To get the eligibility?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Inclination of benefit information. Yes, ma'am, I can help you. And what is your callback number, please?
[CUSTOMER][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 02566557
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And [PII], any information for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So, I do show that he is the subscriber on the supplemental policy, and the supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] This is not major medical insurance. This is only a supplement to his primary insurance that is designed to help with co-pays, deductibles, and co-insurance amounts of covered services.
[CUSTOMER][NEUTRAL] OK, so you all wouldn't require coordination benefits with the primary.
[AGENT][POSITIVE] That is correct.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] All right, I, I appreciate you checking that for me and then do you have a reference number?
[AGENT][NEUTRAL] Yes, ma'am. Uh, you would use my name along with today's date.
[AGENT][NEUTRAL] And then if you all should end up filing a claim with APO [PII], uh, will you all be doing that?
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] So she, he does have a visit coming up at our facility.
[AGENT][NEUTRAL] Just strictly checking for the eligibility.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, sorry. I think I do have a bit of a delay. I'm so sorry about that. And I'm having a bit of audio issues as well.
[AGENT][NEUTRAL] OK, so if there
[AGENT][NEUTRAL] That's OK. Now, I'm not sure. It may be um.
[AGENT][NEUTRAL] Well, I've been having them uh myself so I don't know either way we'll do the best we can, but what I was gonna say if you will do file a claim with us.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For him on this policy, you will also need a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] For us for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And then process our claim we do have a portal that claim status should be able to be checked in and our portal website is secured.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] I appreciate your help this morning, [PII]. And I hope you have a great rest of the day.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Uh, well, you're welcome. Yes, ma'am. Well, thank you so much. I hope you do too. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] That is all for now. Thank you.
[AGENT][POSITIVE] OK, well then, thank you again for calling APL. Have a wonderful day.
[CUSTOMER][POSITIVE] You as well thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.