AccountId: 011433970860
ContactId: 33985c7c-d8fe-442a-bc81-bc4fc080f350
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296369 ms
Total Talk Time (AGENT): 120076 ms
Total Talk Time (CUSTOMER): 94491 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/33985c7c-d8fe-442a-bc81-bc4fc080f350_20250529T19:45_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh hello, [PII]. This is [PII] calling from provider office Jackson Memorial Hospital. Uh, I want to discuss with you regarding a patient eligibility.
[AGENT][NEUTRAL] OK, you're needing eligibility for a number, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] Yes, I can help you with that, and I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] It, it's [PII]
[AGENT][NEUTRAL] OK, [PII], thank you. And what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII]. It's a direct line.
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] 56.
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Um, sure, just a second.
[CUSTOMER][NEUTRAL] So the member policy number is
[CUSTOMER][NEUTRAL] It is, uh,
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So the member policy number is 01568622 M as in Mike, L as in Lima, number 8.
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And any information [PII] that I provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh sorry. Patient name um name and date of birth, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] It is [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do, and any, again, any information that's provided will be a verification of benefits and not a guarantee of payment. I do show that he is a dependent on the supplemental policy, and this supplemental policy is active, Maria, with an effective date of [PII].
[AGENT][NEUTRAL] And if you all will be filing a claim with us for him, you will also need to include a copy of the primary insurance company's explanation of benefits because we do have to have that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we have processed our claim here we do have a portal that you all should be able to check claim status in and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So, as I understood, the patient is active from [PII] and still active, right?
[AGENT][NEUTRAL] No, ma'am, I said [PII].
[CUSTOMER][NEUTRAL] Yes, [PII] and still active, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. One moment.
[CUSTOMER][NEUTRAL] OK. So what would be the claim timely filing limit so that we can submit this claim?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] There is no timely filing limit, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, kindly help me with the claim mailing address.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] Attention claims department.
[CUSTOMER][NEUTRAL] Um, just.
[CUSTOMER][NEUTRAL] Um, could you please help me with the zip code once again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got it. Thank you so much for your help. And lastly, do you have any call reference number for this one?
[AGENT][NEUTRAL] You would use my name and today's date, and again, my name is [PII]. It is spelled [PII]
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] OK, [PII]. Well, you're very welcome. So that is all I can help you with. Thank you again for calling APL and I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Yeah.