AccountId: 011433970860
ContactId: 368868a3-549c-4cf1-94be-a47d39c687e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 622669 ms
Total Talk Time (AGENT): 163776 ms
Total Talk Time (CUSTOMER): 269768 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/368868a3-549c-4cf1-94be-a47d39c687e4_20241231T19:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. This is [PII], and I'm calling for the office for checking on an eligibility and benefit status for the patient.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits, and I didn't catch your name. Can you repeat your name for me, please?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] Thank you and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Uh, sure. [PII]. It's a direct line and can you give me a second for the uh member ID? Just a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you so much. Just a second, almost done.
[CUSTOMER][NEUTRAL] OK, ma'am. Uh, thank you. Uh, the, uh, member ID is 02255680, M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] Uh, ma'am, the patient's full name is [PII]. [PII] is the patient's date of birth.
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And um I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Still active?
[AGENT][NEUTRAL] Yes, it's still active.
[CUSTOMER][NEUTRAL] And can you also please uh help me uh with the group number of the patient?
[AGENT][NEUTRAL] The group number is 256-68.
[CUSTOMER][NEUTRAL] Thank you. Uh, and ma'am, uh, is this a PPO HMO, uh, the plan name, please?
[AGENT][NEUTRAL] This is their Medlink policy. It's a supplemental gap insurance.
[CUSTOMER][NEUTRAL] Uh, supplemental gap insurance. Um, thank you so much and uh I also wanted to ask you, ma'am, um, just a moment, please.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh, thank you so much.
[CUSTOMER][NEUTRAL] Uh, and ma'am, uh, is the claim's mailing address [PII]?
[CUSTOMER][NEUTRAL] [PII], OK. [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And the payer ID is 73124, 60801.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Oh, thank you so much. Uh, just a moment, please. Uh, and, uh,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any deductible amount for this patient, ma'am?
[AGENT][NEUTRAL] Um, let me take a look and see. Um, no, there's no deductible unless for the emergency room, there is a $200 deductible. Um, let me see if inpatient has anything.
[AGENT][NEUTRAL] And there's no deductible for inpatient, so it's just the $300 for emergency rooms.
[CUSTOMER][NEUTRAL] OK. Uh, just a moment, please.
[CUSTOMER][NEUTRAL] Uh, ma'am, actually, I have an address. Uh, can you just verify whether it's the same, I mean, that it belongs to [PII].
[AGENT][NEUTRAL] I'm not familiar with that address, no, ma'am.
[CUSTOMER][POSITIVE] Oh, thank you so much. And ma'am, I have 3 more patients. Is it possible for you to help me with that other 3?
[AGENT][NEUTRAL] Sure, hold on one moment.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and the next member's policy number?
[CUSTOMER][NEUTRAL] Uh, just a moment, please. Just a second.
[CUSTOMER][NEUTRAL] One moment, ma'am.
[CUSTOMER][POSITIVE] Uh, ma'am, almost done. It's loading. Sorry for the delay.
[CUSTOMER][NEUTRAL] Uh, ma'am, uh, thank you so much, ma'am. And uh the member ID that I have is uh 00 sorry, 02260508. M as in Mike, L as in Lima, number [PII].
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, sure, ma'am. Uh, the patient's full name is uh [PII]. [PII] is the patient's date of birth.
[AGENT][NEUTRAL] Thank you for that. And again, all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, and it's been effective for [PII] since [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII], uh, same. Uh, and the group number, please?
[AGENT][NEUTRAL] 224-86.
[CUSTOMER][POSITIVE] Uh, thank you. Um, thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, for this patient as well, uh, ma'am, uh, no deductible.
[AGENT][NEUTRAL] Um, let me look at their policy. Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] So I'm just waiting for the policy documents to come up here. Hold on one moment.
[CUSTOMER][NEUTRAL] Uh, sure, ma'am.
[AGENT][NEUTRAL] OK, so for this policy, I'm not showing any deductibles for outpatient or
[AGENT][NEUTRAL] Impatient. I just wanted to double check, but yeah, there's no um
[AGENT][NEUTRAL] There's no deductible for either.
[CUSTOMER][POSITIVE] Uh, no issues, ma'am. Thank you.
[CUSTOMER][POSITIVE] Oh, thank you so much. Uh, shall I go with the um next member ID that I have, ma'am?
[AGENT][NEUTRAL] Hold on one moment. I have to note each policy. Hold on 1 2nd.
[CUSTOMER][NEUTRAL] Oh, sure, sure, sure, sure, ma'am.
[AGENT][NEUTRAL] And the next member's policy number?
[CUSTOMER][NEUTRAL] Um, the next policy ID that I have is 31,860,890,900.
[AGENT][NEUTRAL] OK, that's not an APL policy number. Um, it should start with a 01 or 02.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh, but, uh, because, ma'am, uh, the name insurance name is showing as American Public Life. So.
[AGENT][NEUTRAL] Right, but you see how that policy number is way longer than all the other ones. Yeah, so that's not one of our policy numbers.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Do you, do you think maybe that's the social?
[CUSTOMER][POSITIVE] OK. Uh thank you.
[CUSTOMER][NEUTRAL] Uh, no, no, ma'am. That was the member ID. Uh, no issue, ma'am. Uh, no issues. I'll just verify again. I have a last patient for today. Can you please help me with that as well?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, whenever you're ready for the member ID, ma'am.
[AGENT][POSITIVE] Oh, yes, I'm ready.
[CUSTOMER][NEUTRAL] Uh, the member ID that I have is 01973184, M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, sure, ma'am.
[CUSTOMER][NEUTRAL] Uh, for this one,
[CUSTOMER][NEUTRAL] Just a moment. Uh, the patient's full name is uh [PII], [PII] is the patient's date of birth.
[AGENT][POSITIVE] Thank you for that. And I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][POSITIVE] Oh thank you. The group number, please?
[AGENT][NEUTRAL] It's 21018.
[CUSTOMER][POSITIVE] Yeah, thank you so much and everything remains the same right, ma'am. It is supplementary gap policy, uh, same claims mailing address and the payer ID and no deductible for this patient as well.
[AGENT][POSITIVE] Right, that's correct, no deductible.
[CUSTOMER][POSITIVE] Uh, thank you so much, ma'am. Uh, and, uh, is there any call reference number for our call or I can use your name?
[AGENT][NEUTRAL] Um, there's no call reference number, but yes, you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much, ma'am. Thank you so much for assisting me today. Have a great day and happy New Year.
[AGENT][POSITIVE] You're very welcome, um, [PII], well, thanks for calling APL and I hope you have a happy New Year as well.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye-bye.