AccountId: 011433970860
ContactId: 210a6bd0-1f3c-4904-a835-846d43ce6a40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299269 ms
Total Talk Time (AGENT): 128330 ms
Total Talk Time (CUSTOMER): 88405 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/210a6bd0-1f3c-4904-a835-846d43ce6a40_20250409T19:23_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. That is [PII], and I am calling from Vital MD Group Holding, and I need the member's eligibility.
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility, Ms. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] with extension [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] And will you please repeat your name?
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] 019.
[CUSTOMER][NEUTRAL] 793.
[CUSTOMER][NEUTRAL] 55, then it's letter MLS.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient, [PII]?
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] All right, and you say you need eligibility. OK, it looks like this policy was effective on [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let me see if there's any other policies. One moment.
[AGENT][NEUTRAL] OK, looks like we do have a new policy for this member. Um, let me know when you're ready for that new policy.
[CUSTOMER][POSITIVE] Yes, I'm ready. You can help me with the effective date.
[AGENT][NEUTRAL] Effective date is [PII] and it is active at the moment.
[AGENT][NEUTRAL] And the new policy number is 0229.
[AGENT][NEUTRAL] 8031.
[CUSTOMER][NEUTRAL] OK, just to confirm, you said 02298031.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, uh, there will be any letters at the end?
[AGENT][NEUTRAL] I'm sorry, any what?
[CUSTOMER][NEUTRAL] Any letters alphabets at the end?
[AGENT][NEUTRAL] Oh, we don't need those. Um, you can use them in the ML 8, but it is, it is not needed. It's not required.
[CUSTOMER][NEUTRAL] OK, OK, no problem. OK, and I also wanted to confirm the payer ID. Is it 64556?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, the payer ID on this one, this is one of our secondary supplemental plans for the major medical, um, so the payer ID on this one is 60801. Now, the claims on this one needs to be sent by fax or mail because we need the primary EOB attached to it.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] We cannot submit through payer ID?
[AGENT][NEUTRAL] No, because we need the unless you can send the the primary EOB attached electronically, then you can use it, but we need the EOB. If the EOB is not there, it's, it's not gonna be a complete claim.
[CUSTOMER][NEUTRAL] OK, help me with the fax number on which we can send.
[AGENT][NEUTRAL] OK, fax number is [PII].
[CUSTOMER][NEUTRAL] OK, just to confirm [PII]. Any attention?
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][NEUTRAL] Claims department, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] How much will be the time you find to submit this?
[AGENT][NEUTRAL] We don't have how many filing limits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's what I have then you can help me with the call reference.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK, thank you so much for all your help.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today, sir?
[CUSTOMER][POSITIVE] Uh, no, that's all, thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APO. Have a good day.
[CUSTOMER][POSITIVE] You too take care bye.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.