AccountId: 011433970860
ContactId: 221147ae-c6b4-429c-82e9-e326cf00e41c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296010 ms
Total Talk Time (AGENT): 126229 ms
Total Talk Time (CUSTOMER): 107651 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/221147ae-c6b4-429c-82e9-e326cf00e41c_20250206T15:44_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, my name is [PII]. I'm calling from the provider's office for checking the eligibility of a member. Could you please help me on that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You need eligibility only and not benefits. Is that correct?
[CUSTOMER][NEUTRAL] No, I need the eligibility.
[AGENT][NEUTRAL] Only eligibility. You do not need benefit information, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you. And could you spell your name for me, please?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] I mean, it's spelled like as [PII].
[AGENT][NEUTRAL] I'm sorry, one more time, please.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK great thank you and your callback number?
[CUSTOMER][NEUTRAL] My callback number is [PII] is the direct number.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] Yes. The member policy number is 02399290.
[CUSTOMER][NEUTRAL] [PII] as [PII] as in [PII] the [PII].
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And in the information that I do provide would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the, the patient name is [PII] and the date of birth was on [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you say she is a dependent on the supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And Rupe, if there is going to be a claim filed with APO on this policy, we would also have to have a copy of our primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal that you should be able to check claim status and have access to our explanation of benefits.
[AGENT][NEUTRAL] And our portal website is secured. [PII].
[CUSTOMER][NEUTRAL] OK, thank you. And could you please give me the
[CUSTOMER][NEUTRAL] Mailing address for submitting the claim.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][POSITIVE] Mhm thank you.
[CUSTOMER][NEUTRAL] And the payer ID please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. And one more thing, uh, I would like to know which plan type this, uh, member has SPP or POS.
[AGENT][NEUTRAL] This is a supplemental, none of that. This is not, we are not a major medical insurance. This is a supplemental.
[AGENT][NEUTRAL] Medlink policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Thank you. Thank you for the information. And the subscriber name is [PII] and the date of birth was on [PII]. Am I correct?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what did you say his date of birth was?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][POSITIVE] Mhm mhm. Thank you. Thank you for the information. And could you please spell your name for the documentation purpose one more time?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And my name in today's date will be your call reference number also.
[CUSTOMER][POSITIVE] Mhm thank you. Thank you, [PII], for the information that you have provided me with today. I hope you have a wonderful day ahead. Bye.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes ma'am, thank you. I hope you have a very nice day too, and thank you again for calling APL if that's all I can help you with.
[CUSTOMER][NEUTRAL] Mhm. Sure, bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.