AccountId: 011433970860
ContactId: 39b3fca9-00a6-4326-af60-8641b9502ab1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 365859 ms
Total Talk Time (AGENT): 152611 ms
Total Talk Time (CUSTOMER): 160815 ms
Interruptions: 3
Overall Sentiment: AGENT=0, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/39b3fca9-00a6-4326-af60-8641b9502ab1_20250507T15:34_UTC.wav
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[CUSTOMER][NEUTRAL] I I I.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the University of North Carolina Healthcare system. I was calling to verify eligibility for a patient.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK, thank you. And policy number of the patient?
[CUSTOMER][NEUTRAL] Oh, hold on just a second, let me get back on to the page.
[CUSTOMER][NEUTRAL] 2606541
[CUSTOMER][NEUTRAL] My man [PII]
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII] [PII].
[CUSTOMER][NEUTRAL] Well, if you hear your voice.
[AGENT][NEUTRAL] And date of service and build amount.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, we haven't sent it yet. That's why I was calling to verify information so we can submit it. The payment was saying on um.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] [PII] though, [PII].
[AGENT][NEUTRAL] OK. Uh, looks like this policy is effective [PII]. It's currently active. And do you need the benefits for that?
[CUSTOMER][NEUTRAL] No, just the um network if there is a network um the payer ID and claims address please.
[AGENT][NEUTRAL] Um, there's no network, it's a supplemental policy. Our payer ID is 60801.
[AGENT][NEUTRAL] And the claims address is [PII].
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] 73124-8950
[CUSTOMER][NEUTRAL] 8950 OK so this is not a um.
[CUSTOMER][NEUTRAL] How can you said it was a supplemental plan, not a regular commercial plan.
[AGENT][NEUTRAL] Correct. It's not like a major medical, it's just a supplemental policy.
[CUSTOMER][NEUTRAL] So a major medical, OK, because yeah, they're trying to file it as a major medical.
[CUSTOMER][NEGATIVE] So that wouldn't get paid um.
[AGENT][NEUTRAL] Well, it depends on the benefits. They have limited benefits, um, so it depends on what what you're filing for.
[CUSTOMER][NEUTRAL] OK, alright, we'll send it in um.
[CUSTOMER][NEUTRAL] See what happens. Yeah, is there a um reference number um for the call?
[AGENT][NEUTRAL] Uh, it's just my name, [PII], first initial to last name, [PII], and today's date. Can I help with anything else today, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yes, I was trying to get into the, well, trying to register for the portal, but I don't have an account number for a claim that was sent. Only thing I have is this one, but we haven't sent it yet, so.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I didn't know if there was a way to um.
[AGENT][NEUTRAL] Yeah, you actually can't register until we have actually processed that first claim.
[CUSTOMER][NEUTRAL] OK, um, I, we've process, I mean we've sent other claims, but.
[CUSTOMER][NEUTRAL] Is there a way to um.
[CUSTOMER][NEUTRAL] Look to see or it has to be like something current.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So you would have to have like a past uh insured with us.
[AGENT][NEUTRAL] And then, um, to, to see, let me see, I don't think I can tell if you've set it up or not. Let me check though. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I know I haven't set it up but I know.
[CUSTOMER][NEUTRAL] That this is not the first time I've seen a claim come through for APL, so I'm pretty sure we've submitted.
[AGENT][NEUTRAL] What's the tax ID?
[CUSTOMER][NEUTRAL] Claims before you are [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, it looks like you've got several accounts set up in here, but it looks like it would be like for each, each of your employees that's checking status, so it's just a it's several different people, so.
[CUSTOMER][NEUTRAL] So there's no way to get access um knowing that we've already have claim submissions to you all just not this one hasn't been currently submitted.
[AGENT][NEUTRAL] Yeah, the only way so it looks like everybody has set this up as an individual user, so it's you don't have like a whole group access.
[AGENT][NEUTRAL] Everyone's just set up an individual.
[CUSTOMER][NEUTRAL] Right, that's what I'm saying you don't have access to give me a uh account number so that I can register the account.
[AGENT][NEUTRAL] No, I don't. It's these are all personal, it looks like personal employees. So if you would have to have a like a.
[CUSTOMER][NEUTRAL] No, I'm saying that a patient account number that I can use to uh for one that we've already sent that we could that I could use that account number to um register for me.
[AGENT][NEGATIVE] No, I, I don't, I don't have a way to search by that.
[CUSTOMER][NEUTRAL] But you just said you were looking at claims we submitted before you couldn't get one of those patient numbers and so.
[AGENT][NEUTRAL] No I can't, I, I can't see claims that have been submitted. I can just see that people have set up the account. I can't see what provider or patient number they've set it up with.
[AGENT][NEUTRAL] I can just access our admin site to see, yes, your facility has set up.
[AGENT][NEUTRAL] Uh, accounts under this tax ID.
[AGENT][NEUTRAL] But I can't see what patient number is associated with it. So you would have to pull a patient number from your system and then set it up with that information.
[CUSTOMER][NEUTRAL] Yeah, see, the thing about it, I don't know which patients have we submitted claims for or not. The, uh, we have a large organization. The only time I see them is when they need to go out, not after they've been sent out.
[AGENT][NEUTRAL] Yeah, and
[AGENT][NEUTRAL] Yeah, and I don't
[CUSTOMER][NEUTRAL] I'm on the front end, not the tail end.
[AGENT][NEUTRAL] Right, yeah, I understand. I just, I can't see the patient information submitted for these user accounts. I can't see how they, what patient, yeah, sorry about that.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] OK, uh huh thank you have a good day.