AccountId: 011433970860
ContactId: 2514fcea-43fd-4ce6-8214-90cd20db0d35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228380 ms
Total Talk Time (AGENT): 86533 ms
Total Talk Time (CUSTOMER): 99070 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/2514fcea-43fd-4ce6-8214-90cd20db0d35_20250303T19:43_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL speaking. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Brag Incorporated. I need to check on a member's medical eligibility benefits and the claim submission information. Could you please help me with that?
[AGENT][NEUTRAL] Sure, I can verify eligibility for you and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Policy number I'm having is D as in Delta 445.
[CUSTOMER][NEUTRAL] 04814.
[AGENT][NEUTRAL] Uh, it's not one of our policy numbers. Do you have the uh the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII]. It's spelled as [PII]
[CUSTOMER][NEUTRAL] Last name is [PII].
[AGENT][NEUTRAL] OK, and the date of birth?
[CUSTOMER][NEUTRAL] Date of birth for [PII], it's on [PII].
[AGENT][NEUTRAL] OK, one moment. You said last name is [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check with my subscriber name because previously I have uh uh validated with subscriber name. Can I provide you that?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The mem subscriber's first name is [PII].
[AGENT][NEUTRAL] OK, and Miss [PII], do you have a call, OK, go ahead.
[CUSTOMER][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I do have an extension.
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] OK, thank you. And so you say you're calling to verify eligibility and benefits for this patient, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, well, when you're ready, Ms. [PII], uh, I can give you the policy number they have with our company. That number you gave initially it's not one of our policy numbers.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me know when you're ready.
[CUSTOMER][NEUTRAL] Yeah, please provide me that.
[AGENT][NEUTRAL] OK, it's 2, it's 258-2808.
[CUSTOMER][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] 258-2808. OK. And uh may I know the group number and the plan type?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Sure. The group number is 70062.
[AGENT][NEUTRAL] And the policy is a limited medical indemnity plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So does this plan cover BME?
[AGENT][NEUTRAL] No, DME is not covered under the policy.
[CUSTOMER][NEUTRAL] OK, that's what I need to know because we are submitting the claims for DME so DME is not a covered benefit. Great, thank you. And for my documentation purpose, may I know the uh name of your insurance, uh, the correct spelling of your name and the reference number for this call?
[AGENT][NEUTRAL] Our insurance name is A as in apple, P as in Peter, L as in Lima.
[AGENT][NEUTRAL] And my name is [PII], last initial [PII], and we don't give reference numbers, but if you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] OK. Thank you. And you stated it's a limited indemnity policy, so DME is not a covered benefit under the plan, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much, [PII], for your assistance. Have a great day ahead. Take care.
[AGENT][POSITIVE] Alright, you're welcome. Thanks for calling APL bye.
[CUSTOMER][NEUTRAL] Yeah. Bye-bye.