AccountId: 011433970860
ContactId: 34d35caa-24a6-4aa7-9dac-bdc3eaa322f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226399 ms
Total Talk Time (AGENT): 101988 ms
Total Talk Time (CUSTOMER): 108072 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/34d35caa-24a6-4aa7-9dac-bdc3eaa322f3_20250210T16:22_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was trying to verify patient's eligibility and see if you all provide uh benefit facts backs.
[AGENT][POSITIVE] Yes, we do provide fact backs and I'll be more than happy to help you with the eligibility. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] we're at.
[CUSTOMER][NEUTRAL] Yes ma'am. My name is [PII] Contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] 656-537.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] It give me I need that.
[CUSTOMER][NEUTRAL] I mean this this month.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, member's name is [PII], and his date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] It's so important.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I went ahead
[AGENT][NEUTRAL] OK, so this member was on the policy?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, they're no longer active.
[CUSTOMER][NEUTRAL] Ties with identity, we went ahead and did the cancellation.
[AGENT][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Can you give his date of birth one more time? I'm sorry.
[CUSTOMER][NEUTRAL] Uh yes, ma'am. His date of birth is [PII].
[AGENT][NEUTRAL] OK, I just want to make sure. So hold on one second, let me see.
[CUSTOMER][NEGATIVE] Because if the website wasn't optimized.
[AGENT][NEUTRAL] When it became
[CUSTOMER][NEGATIVE] To spend on the Google ads was uh for nothing.
[CUSTOMER][NEUTRAL] So we went ahead and turned down the the.
[CUSTOMER][NEUTRAL] And then of course.
[AGENT][NEUTRAL] Trying to see when it became an individual because he's no longer active on the policy, the policy is active for the policyholder, but he's a spouse on the policy and he's no longer active. So I'm trying to see when did that happen.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, OK, so we must have it in backwards in our computer is his wife [PII] the policy holder?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] OK, so the verification is for her.
[AGENT][NEUTRAL] Oh, it's for her, OK.
[CUSTOMER][NEUTRAL] We have him in, yes, ma'am, we have him in the computer as the policyholder, but it's for her and her date of birth is [PII].
[AGENT][NEUTRAL] OK, hold on one second and let me go to her.
[CUSTOMER][NEUTRAL] End of November
[CUSTOMER][NEUTRAL] So it got turned down to like.
[AGENT][NEUTRAL] OK, so yes, for her, the policy has been active since [PII], and let me see what type of policy she has, so I can get you the fax back. Hold on one second.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Set
[CUSTOMER][NEUTRAL] Maybe go back to like.
[CUSTOMER][NEUTRAL] 4.
[CUSTOMER][NEUTRAL] And let's
[AGENT][NEUTRAL] OK. So on the fax back, you'll see the calendar year maximum deductible, all the frequencies, limitations, all the ways to file a claim, and then there's a list of covered codes and the benefit amount that would be paid towards that code. Um, if the code you're looking for isn't on here, then it won't be covered by her policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect that's what I needed.
[AGENT][NEUTRAL] Alrighty, well, um, may I have a good fax number for you to send it to?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And do I need to put attention [PII]?
[CUSTOMER][POSITIVE] Yes ma'am, you can.
[AGENT][POSITIVE] All right, well, I will go ahead and send this over to you now. And was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No ma'am, that's it thank you.
[AGENT][POSITIVE] You're very welcome. Well, thank you so much for calling APL Marquette. I hope you have a great day. Well, a great week.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Yes.