AccountId: 011433970860
ContactId: 3581154d-6078-4962-8ae5-4ae5040172d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 310730 ms
Total Talk Time (AGENT): 99602 ms
Total Talk Time (CUSTOMER): 147315 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/3581154d-6078-4962-8ae5-4ae5040172d8_20250331T18:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, hi, my name's [PII]. I'm calling from Southern Eye Associates. I'm not sure if I have the right extension, but I'm trying to check to see if a code needs a, uh, prior authorization.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] Sure it's gonna be [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] OK, that's D like dog 437314-02.
[AGENT][NEUTRAL] OK, that the number is not our policy number. I start with the 0. Do you have the card with you?
[CUSTOMER][NEUTRAL] I do and I called the number on the back and she said that he um for that he I would have to be directed to APL and this is the number she gave me.
[AGENT][NEUTRAL] OK, so on the card it should be.
[AGENT][NEUTRAL] A number starting with either 01 or 02.
[CUSTOMER][NEUTRAL] Nope, not his. Let me see, let me check, uh, no.
[CUSTOMER][NEGATIVE] I don't have that. So am I gonna have to call back to because it it says on the back 90 degree benefits and that's who I called first and then because that's the only number on there and they directed me to you guys. So do I need to call back to 90 Degree and tell him he's not with APL?
[AGENT][NEUTRAL] No, I'm not stating that he's not with APL. May I please have the member's first and last name or social?
[CUSTOMER][NEUTRAL] Um, sure, his name is [PII] [PII].
[AGENT][NEUTRAL] And could you spell the last name for me please?
[CUSTOMER][NEUTRAL] Sure, it's [PII]
[AGENT][NEUTRAL] And [PII] is spelled [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] And I do have a social I found that if you needed it.
[AGENT][NEUTRAL] And the date of birth was [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] And may I please
[AGENT][NEUTRAL] OK, so you're calling in to see if a pre-authorization is required for this member?
[CUSTOMER][POSITIVE] Yes, that's, yes ma'am.
[AGENT][NEUTRAL] OK, so for this member policy it is showing that no pre-op is required and for American Public Life, it will be listed as the policy slash cert on the card and that policy number is 02.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right now like
[AGENT][NEUTRAL] 51
[AGENT][NEUTRAL] 3034.
[CUSTOMER][POSITIVE] But gonna heal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that what we need to be billing his claims under then and not what's on the card that he gave us, do you know?
[AGENT][NEUTRAL] The way that it works, it will go to benefit in a car which is 90 degree first. Once it goes to them, then it will cross over to us.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I just didn't know if I needed to change the policy number, but I'll just put a note.
[CUSTOMER][NEUTRAL] Let's see number just in case 02513.
[AGENT][NEUTRAL] OK, so on the card, are you seeing where it says medical ID?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, so on the front it says member MAU and then it just says employee ID employee name and then it just says medical coverage employee, um, and then there's like the pharmacy, there's vision, so he must have gave us the wrong card.
[AGENT][NEUTRAL] OK, so he didn't give you the card.
[AGENT][NEUTRAL] Yes, because, um,
[AGENT][NEUTRAL] On the card it's gonna have the policy cert, the effective date, and then also the medical ID number.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, alright, I'll reach out to the patient and see if we can get the correct card then from him.
[AGENT][NEUTRAL] OK, and I did give you the correct policy number for us, correct?
[CUSTOMER][NEUTRAL] Yes ma'am, the 02513034.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK perfect um yep OK I will reach out to the patients see if I can get that correct card and I do appreciate it. Do you have like a call reference number for this?
[AGENT][NEUTRAL] The call reference would be my first name [PII], last initial of H and today's date.
[CUSTOMER][POSITIVE] OK great thank you so much for your help.
[AGENT][POSITIVE] You're welcome and thank you [PII] for calling American Public Life. Have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] No.