AccountId: 011433970860
ContactId: 36980a10-152d-46c0-9351-8b35b4aa1a7f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 985539 ms
Total Talk Time (AGENT): 215635 ms
Total Talk Time (CUSTOMER): 493752 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/36980a10-152d-46c0-9351-8b35b4aa1a7f_20250421T14:39_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] Hi, good morning, my name is [PII] we're the provider. Can you please help me with um eligibility uh for.
[CUSTOMER][NEUTRAL] 222 patients. Let me make sure they don't have.
[CUSTOMER][NEUTRAL] Let me see, let me see how many, how many there is. Give me one second.
[CUSTOMER][NEUTRAL] Hold on, I'm just making sure because you guys are very popular. A lot of people have American Pub Life, so I'm just trying to see how many American Pub Life there is. American Pub Life. OK, 3. How many American Pop Life are you able to help me with?
[AGENT][POSITIVE] I can help you with those. That's fine.
[CUSTOMER][NEUTRAL] There's like 3 and I think I think I see 4 now. Oh my god, you they're popular.
[AGENT][NEUTRAL] May I have a callback number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] And may I have one of the policy numbers?
[CUSTOMER][NEUTRAL] OK, hold on one second, so.
[CUSTOMER][NEUTRAL] OK, so then then she's not trying she's she's not, um, OK, so it's gonna be these, these two, OK, so I have, I have, I have 4, can we do 4?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so let me
[CUSTOMER][NEUTRAL] Let me hold on one second, let me pull up the policy number. Give me 1 2nd please.
[CUSTOMER][NEGATIVE] This is a no, OK, the first one is gonna be, hold on, give me one second, everything I lost everything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, hold on, I'm sorry I lost everything. Give me one second, 12, OK, 1.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK, this one.
[CUSTOMER][NEUTRAL] OK, 3, OK, I think it was 3.
[CUSTOMER][NEUTRAL] What was what was this one here? Sorry, I'm losing track of where I am. Give me one second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, I lost everything.
[CUSTOMER][NEGATIVE] My system froze. OK, OK, I got everything now.
[CUSTOMER][POSITIVE] OK, perfect. Let's just make check something.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. I'm sorry. So the member ID is going to be, uh, I froze. OK, 02576690.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy you're calling in for eligibility for this member. It does show that it is currently active.
[CUSTOMER][NEUTRAL] Yes, and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And does she have, and does she have, um, let's see, hold on, outpatient urgent care coverage?
[AGENT][NEUTRAL] Go ahead
[AGENT][NEUTRAL] So you're needing the eligibility and benefits for all the members as well?
[CUSTOMER][NEUTRAL] Yes, I just want, yeah, I wanna make sure that they do have, have that out, they do, they do have that, uh, coverage.
[AGENT][NEUTRAL] OK, so for this member, it is showing that it's currently active with the effective date of [PII]. You're calling in for urgent care benefits, verification of coverage does not guarantee the payment of the claim.
[AGENT][NEUTRAL] This member has up to $500 per occurrence that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It will not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII], on this member?
[CUSTOMER][POSITIVE] Yes, OK, so perfect. So so she does have that outpatient uh urgent care coverage, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK perfect and what is the mother, the mother is the subscriber, um, what is her date of birth?
[AGENT][NEUTRAL] Who's date of birth?
[CUSTOMER][NEUTRAL] The mother because she's she's the subscriber, right? the mother?
[AGENT][NEUTRAL] Who, OK, but who
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, that is the subscriber route you will have to get that information of the date of birth or anything else from the member. I can't disclose that information.
[CUSTOMER][NEUTRAL] Uh, you can't do that? OK.
[CUSTOMER][NEUTRAL] Uh, because they put the father because the father is not the uh the father is not the subscriber, right? Oh, here, oh, I'm sorry, I found his date of birth [PII], the father, OK, hold on, let me fix that.
[CUSTOMER][NEUTRAL] They because they put it wrong then let me add him.
[AGENT][NEUTRAL] Who is the father? The father is not listed on this policy.
[CUSTOMER][NEUTRAL] OK, one sec.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], [PII]. He's he's he's the, he's the, he's the subscriber.
[AGENT][NEUTRAL] Yes, OK, you said the mother was [PII].
[CUSTOMER][NEUTRAL] I'm sorry, I didn't realize. I thought she was [PII] was a girl. I'm sorry.
[CUSTOMER][NEUTRAL] OK, so let me, let me add him.
[CUSTOMER][NEUTRAL] Um, so it's, it's, and this is [PII] or is it [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, let me add it. Let me fix that that the subscriber one second.
[CUSTOMER][NEUTRAL] OK, so search.
[CUSTOMER][NEUTRAL] OK, [PII]
[CUSTOMER][NEUTRAL] Uh, [PII] OK, he's [PII]. OK, search.
[CUSTOMER][NEUTRAL] Oh, here he is OK.
[CUSTOMER][NEUTRAL] Yeah, I found him. He lives at, yeah, oh the he lives at [PII], OK.
[CUSTOMER][NEUTRAL] [PII]. OK, let me add him. I'm sorry for taking a little while trying to make sure we have it all correct.
[CUSTOMER][NEUTRAL] OK, perfect. OK, and we have your address. OK, and the group number is it, what is the group name gonna be?
[AGENT][NEUTRAL] The group name is Fisher Island Club.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Fisher Island Club CLUB.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much and what is the group number gonna be?
[AGENT][NEUTRAL] It is 2488924882.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, perfect. OK, let's see and then let me go ahead and, and [PII], how do you spell your name?
[AGENT][NEUTRAL] It is spelled [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] I last initial of [PII] and today's date will be used as the call reference.
[CUSTOMER][NEUTRAL] OK, let me go ahead, yes, alright, perfect, let me go ahead and save this one and then we can go on to the next one, please. OK.
[CUSTOMER][NEGATIVE] Let me save it.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] No financial responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sorry, because I missed something that I didn't verify so I have to make sure I got everything correct right.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] OK, yeah, yep, now let me go ahead and save this and we'll go on to the next one.
[CUSTOMER][POSITIVE] OK this book.
[CUSTOMER][NEUTRAL] [PII] let me see.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, from no, from APL and their insurance.
[CUSTOMER][POSITIVE] And verified um UMR through GX OK perfect.
[AGENT][NEUTRAL] OK. [PII], I'm gonna need to have the next member.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] I can't continue to be on hold for you to enter notes.
[CUSTOMER][NEUTRAL] Yes, yes, I'm
[CUSTOMER][NEUTRAL] OK, hold on one second. I'm gonna pull up the next one right now.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] OK, it's I'm sorry, just the system's a little slow.
[CUSTOMER][NEUTRAL] OK, I'm pulling up the next one right now.
[CUSTOMER][NEUTRAL] OK, the next one, his name is gonna be, it's loading.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] I appreciate your patience.
[CUSTOMER][NEUTRAL] Where you go? OK, he's right here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, the next one.
[CUSTOMER][NEUTRAL] OK, his policy number is gonna be.
[CUSTOMER][NEUTRAL] 02141739.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Date of birth, please?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] And thank you for verifying this member you're calling in for eligibility and outpatient benefits as well for this member verification of coverage.
[CUSTOMER][NEUTRAL] Yes, this is
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Verification of coverage does not guarantee the payment of the claim. This policy is currently active with the effective date of [PII]. For outpatient, the member does have up to $500 per calendar day. Again, that will go towards the primary insurance deductible, co-insurance, or co-pay. Is there anything else for this member that you would like for me to assist you with?
[CUSTOMER][NEUTRAL] Yes, so this is, this is gonna be different. This is not gonna be for urgent care. This is for diagnostic. They have diagnostic coverage.
[AGENT][NEUTRAL] That is up to the $500 per calendar day.
[CUSTOMER][POSITIVE] OK, perfect. OK. Mm.
[CUSTOMER][POSITIVE] OK perfect and let me go ahead, make a note.
[CUSTOMER][NEUTRAL] OK, so this is mm, put that verified.
[CUSTOMER][NEUTRAL] And he's the subscriber, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And then what is his group name gonna be?
[AGENT][NEUTRAL] The group name is BOM.
[AGENT][NEUTRAL] NIN.
[AGENT][NEUTRAL] Volvo.
[CUSTOMER][NEUTRAL] [PII], how do you spell that?
[AGENT][NEUTRAL] Volvo like the car.
[CUSTOMER][NEUTRAL] Oh, Volvo, V O L V O. OK, so B O N I B O N N I N Volvo. OK, perfect. Is is the group number 24,480?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Perfect. OK, let me go ahead and add your name and then.
[CUSTOMER][NEUTRAL] OK, so your name was?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 04.
[CUSTOMER][NEUTRAL] OK, let me go ahead and pull up the next one.
[CUSTOMER][NEUTRAL] OK, and right, we said he's just a subscriber, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so let me go ahead and pull up the next one.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It says sorry it's like the system's a little slow.
[AGENT][NEUTRAL] Do you have that member's policy number?
[CUSTOMER][NEUTRAL] Yes, I'm sorry it's, it's still loading. I'm sorry, the system's a little slow.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Yeah, just everything just slow today.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, it's it's popping up now.
[CUSTOMER][POSITIVE] Let me just grab that and go ahead. I appreciate your patience today.
[CUSTOMER][NEGATIVE] Sometimes the system's slow, sometimes just.
[AGENT][NEUTRAL] OK, but again I, I can't continue to stay on hold for you to enter your notes in. I do have other calls in the queue, so I'm gonna need the policy number and I can give you that information and then we have to move to the next one.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No this is
[CUSTOMER][NEUTRAL] Yes, yes, no, I, I, I didn't put any notes. I did not put any notes. I, I just was just trying to, everything was trying to load, that's all.
[CUSTOMER][NEGATIVE] So now now she's pulling up yeah our systems have been slow all day.
[CUSTOMER][NEUTRAL] OK, so her policy number is gonna be for this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, OK, 02583680.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And you're calling in for benefits for this member as well?
[CUSTOMER][NEUTRAL] Yes, and this is for out outpatient.
[AGENT][NEUTRAL] And is there a specific, go ahead.
[CUSTOMER][NEUTRAL] Outpatient urgent care.
[AGENT][NEUTRAL] And for this member for outpatient verification of coverage does not guarantee the payment of the claim. This member does have up to $750 per calendar day with the effective date of 11 of $25. This policy will cover sickness and injury only and also go towards the primary insurance deductible, co-insurance, or co-pay. Is there any other information you would like for me to verify for this member?
[CUSTOMER][NEUTRAL] Um, so, so I wanna make sure I understand, so just to confirm, they do have that, um, outpatient urgent care coverage, right?
[AGENT][NEUTRAL] Up to the $650 per calendar day.
[CUSTOMER][POSITIVE] OK perfect. Alright, so it's good to know that they have that and they work for Steiner Atlantic Corp, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and it's 23 the number is 23078, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] And the husband is the husband is the subscriber [PII]. Alright, perfect. Now thank you so much for everything. I really appreciate all your help.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No thank you have a great have a great Monday.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Enjoy the rest of your day.
[CUSTOMER][NEUTRAL] Bye bye you too.