AccountId: 011433970860
ContactId: 29556e3d-9e69-4407-9ef5-1a751d327a46
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 430140 ms
Total Talk Time (AGENT): 136634 ms
Total Talk Time (CUSTOMER): 141762 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/29556e3d-9e69-4407-9ef5-1a751d327a46_20250623T21:27_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the provider's office to check the patient's medical eligibility. Could you please help me with that?
[AGENT][NEUTRAL] Sure, I can assist you with the eligibility, Mr. [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] and it is a direct line. Could you please spell your name?
[AGENT][NEUTRAL] Sure, that's [PII].
[CUSTOMER][NEUTRAL] OK, it is [PII].
[AGENT][NEUTRAL] Correct, yes. And may I have the patient's policy number? You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, it is D as in Delta, 43600704.
[AGENT][NEUTRAL] Do you see a policy certificate number it's gonna start with a 0 followed by 7 digits. That's gonna be your number.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, so we have to do a name search because that the number is not ours that's for IMA only, OK, um.
[CUSTOMER][NEUTRAL] Could you please check with the member's name and date of birth?
[AGENT][NEUTRAL] Yes, we can do a name search. May I have the spelling of the last name?
[CUSTOMER][NEUTRAL] Yes, the last name spells like [PII], and the first name is [PII], spells like [PII]
[CUSTOMER][NEUTRAL] [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, bear with me, let me see if I can find this number with the name, OK.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] One moment, let me see if I can find this member with the name.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, I don't have.
[CUSTOMER][NEUTRAL] you know.
[AGENT][NEUTRAL] Um, you have a social, maybe I can do a search, I mean a social search.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] As the social is [PII].
[AGENT][NEUTRAL] Can you repeat?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do not
[AGENT][NEUTRAL] OK, there's two last names.
[AGENT][NEUTRAL] OK, I found him.
[AGENT][NEUTRAL] Alright, and you say you're looking for eligibility?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hello. OK, and what type of service is being rendered?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I know the effective date of this member?
[AGENT][NEUTRAL] OK. Effective date on this policy is.
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] OK. It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Could you please provide me the valid member ID?
[AGENT][NEUTRAL] Sure, the policy number is 02587043.
[CUSTOMER][NEUTRAL] Could you please confirm it is 02587043.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] And the plan is still active, right?
[AGENT][NEUTRAL] Yes, it is active at the moment. This is a limited policy.
[CUSTOMER][NEUTRAL] May I know the plan type?
[AGENT][NEUTRAL] Limited indemnity policy.
[CUSTOMER][NEUTRAL] Did you see the plan type like HMO or PPO?
[AGENT][NEUTRAL] It's not an HM or a PPO. It's a commercial plan.
[CUSTOMER][NEUTRAL] It is a limited indemnity plan, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] May I know the group number?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Bear with me.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, the group number for this one is 70058.
[CUSTOMER][NEUTRAL] May I know the payer ID?
[AGENT][NEUTRAL] OK, let me see what's the payer ID on this 11 moment while I get that information, Mr. [PII], what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Jefferson Davis Emergency Group.
[AGENT][NEUTRAL] OK. All right. The payer ID is 64556.
[CUSTOMER][NEUTRAL] 7.
[CUSTOMER][NEUTRAL] Claims mailing address.
[AGENT][NEUTRAL] The address is [PII] [PII].
[CUSTOMER][NEUTRAL] OK. Could you please confirm as of today, this number is active and the effective date it is [PII]. And the plan type it is limited indemnity plan and the group number is 70058. And the payer ID it is 64556. And the mailing address is [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And your name spells like [PII], last name first initial [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Call reference number?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][POSITIVE] Thank you. Thanks for your help. Have a nice day. Bye-bye.
[AGENT][POSITIVE] Yes ma'am. Thank you for calling APM. Bye bye.