AccountId: 011433970860
ContactId: 2d06d514-b016-49e8-8843-6433cb2bfadb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283589 ms
Total Talk Time (AGENT): 124702 ms
Total Talk Time (CUSTOMER): 90574 ms
Interruptions: 0
Overall Sentiment: AGENT=2.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/2d06d514-b016-49e8-8843-6433cb2bfadb_20250228T16:54_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Call me
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check on eligibility. Could you please help me with that?
[AGENT][POSITIVE] Yes, I'd love to help you with eligibility today and could you spell please for me uh your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you [PII] and what's a good call back number I can get for you as well?
[CUSTOMER][NEUTRAL] [PII]. It is a direct line?
[AGENT][POSITIVE] Wonderful and the member's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 01812665, M like Mary, L as in Lima, number 8.
[AGENT][POSITIVE] Wonderful. Give me a moment to get that all pulled up for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Are you having a good day so far?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Good, I'm glad to hear it.
[CUSTOMER][POSITIVE] Thanks for asking. How about you?
[AGENT][POSITIVE] Oh, I'm doing wonderful, thank you for asking. It's a beautiful day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I do have that pulled up. Thank you for your patience. Would you be able to verify for me, please, the insured's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], the last name is [PII], date of birth [PII].
[AGENT][NEUTRAL] Perfect. I do see her here. She's current and active with us with an effective date of [PII]. And then was there any other information you were needing for eligibility today?
[CUSTOMER][NEUTRAL] One moment. Uh, the date is [PII].
[AGENT][NEUTRAL] [PII], yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I, is there a plan type?
[AGENT][NEUTRAL] Uh, it is, uh, the plan name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Supplement gap policy, right?
[AGENT][NEUTRAL] Oh yes, it's a supplemental gap insurance, correct.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hi, yes, I'm sorry. Can you hear me?
[CUSTOMER][NEUTRAL] Yes, uh, is there any group number?
[AGENT][POSITIVE] Yeah, let me find that for you there sure is.
[AGENT][NEUTRAL] I have the group number listed as 23715.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK. Is there any in-network deductibles and how much they make?
[AGENT][NEUTRAL] On deductibles, let me see.
[AGENT][NEUTRAL] Um, I'm not showing any deductible on the policy.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK. May I know the payer ID?
[AGENT][NEUTRAL] Yes, our payer ID is 60801.
[CUSTOMER][NEUTRAL] OK, what are the claim spelling address?
[AGENT][NEUTRAL] The claims mailing address is [PII] and that is in [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. The subscriber relationship it is individual or family?
[AGENT][NEUTRAL] Um, this policy is a single parent policy.
[CUSTOMER][NEUTRAL] OK, this individual policy.
[AGENT][NEUTRAL] A single parent, so one adult with dependent children.
[CUSTOMER][NEUTRAL] OK, this family or spouse?
[AGENT][NEUTRAL] No, it's not a family policy because it doesn't include a spouse, it's a single parent policy, so it includes one policyholder with their dependent children but no spouse.
[CUSTOMER][NEUTRAL] OK. It is an individual policy, right?
[AGENT][NEUTRAL] No, because it has dependent children, it's considered a single parent policy.
[CUSTOMER][NEUTRAL] OK, dependent.
[AGENT][NEUTRAL] Yeah, so it has the dependent children, but only one adult.
[CUSTOMER][NEUTRAL] OK. May I know the subscriber name?
[AGENT][NEUTRAL] Yes, your patient is the subscriber.
[CUSTOMER][NEUTRAL] OK, the relation is dependent on the subscriber name is the patient name, right?
[AGENT][NEUTRAL] Yes, correct, she's the policy holder.
[CUSTOMER][NEUTRAL] OK. Uh, OK. Could you please spell your name?
[AGENT][NEUTRAL] Yes, absolutely. It's [PII], first initial, last name, [PII].
[CUSTOMER][NEUTRAL] OK, thank you. May I know the call reference number?
[AGENT][NEUTRAL] Yeah, the call reference number is my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you for your help. Have a great day and happy weekend. Bye.
[AGENT][POSITIVE] Oh, it's my pleasure, [PII] thank you you too. Thanks for calling APL take care.