AccountId: 011433970860
ContactId: 39cc8297-8f24-4d22-9427-9e9dbe6f6050
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348940 ms
Total Talk Time (AGENT): 192654 ms
Total Talk Time (CUSTOMER): 113161 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/39cc8297-8f24-4d22-9427-9e9dbe6f6050_20250429T16:49_UTC.wav
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[AGENT][NEUTRAL] My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm sorry, you sound muffled. Can you repeat that?
[AGENT][POSITIVE] Yes, my name is [PII]. Thank you for contacting ATL. Can I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling to verify a patient eligibility.
[AGENT][NEUTRAL] I can help with eligibility. With whom am I speaking, please?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Memorial Regional Hospital.
[AGENT][POSITIVE] Great, thank you. [PII], what is that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] We have 02300724 ML7.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And I just need a callback number please, the event that we're disconnected.
[CUSTOMER][NEUTRAL] Yes, my direct number is [PII].
[AGENT][NEUTRAL] OK, thank you. The, the policy went into effect on [PII]. It is active. Now, outside of eligibility, can I help you with any of the benefits for the secondary or gap insurance?
[CUSTOMER][NEUTRAL] Um, no, just wanted to confirm if the patient is active with this policy.
[AGENT][POSITIVE] Absolutely, she is, yeah, this is an active policy.
[CUSTOMER][NEUTRAL] OK, because we.
[CUSTOMER][NEUTRAL] Received a EOB that states.
[CUSTOMER][NEUTRAL] Otherwise.
[AGENT][NEUTRAL] Is this for um
[CUSTOMER][NEUTRAL] We sent the hospital claim for.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What date of service?
[CUSTOMER][NEUTRAL] I'm showing [PII] is the mom.
[CUSTOMER][NEUTRAL] Um, the date of service is [PII].
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, let's look that up.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] Now, I don't have any claims for [PII], because we're the secondary insurance, I'm wondering if uh the EOB isn't maybe from Florida Blue, um.
[AGENT][NEUTRAL] Because she's active with us. Uh, now, um, I'm showing that she has Florida Blue as her, as her primary insurance. Uh, but this is all done through her company, so if they changed it, uh, you know, we don't really know.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, I'm showing that we did send the claim to to APL as primary in error. Um, we do show that he does have active with Blue Cross as primary.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I'm looking at the EOB from APL and it says the patient is no longer an eligible dependent under this policy.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So I was just calling to double check so that we won't, you know, resubmit to you guys as secondary.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh yes, of course, um.
[CUSTOMER][NEUTRAL] If you know,
[AGENT][NEUTRAL] Right, no, no, I understand. Um, so yes, they are active, uh, since [PII]. Um, you know, the only thing I can guess is that it, you know, that at one time it was, it lapsed, but, um, I'm still showing it as being active. Uh, so if you, uh, what date of service do we, uh, are we doing this for, if you don't mind my asking?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, it's for [PII] for [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, I've got
[AGENT][NEUTRAL] OK. I see what the problem is. OK. So it looks like.
[AGENT][NEUTRAL] Uh, [PII] active. I think it's [PII] who isn't, so let me just check here really quick. I see what it is. OK. So, yeah, so it's [PII] who's no longer active. Um, [PII] is, so it's, um, so what she did is she must have dropped him off of her, uh, um, insurance. Yes, so he is not, but she is.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can you tell me the, the date when [PII].
[AGENT][NEUTRAL] Was active?
[CUSTOMER][NEUTRAL] Uh, when the
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, the to and from dates.
[AGENT][POSITIVE] Yes, let's see what we've got here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] Right, I see that. OK.
[AGENT][NEUTRAL] OK, so it looks like um [PII] was active from [PII]. Now, we then jump to the policy that, that I have, you know, that um that you just gave me.
[AGENT][NEUTRAL] That was from 23 to 25, that's current and it only shows um the mother. So yes, I think he he was active from [PII], and then after that, oh.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was just mom.
[AGENT][NEUTRAL] It's just the mother, yes. So, um, so yeah, he definitely is no longer active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. And you said your name is [PII]?
[AGENT][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] OK, and.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And that was all I had for today. Could I just get a call reference number?
[AGENT][NEUTRAL] Yes, my name is [PII] letter of my last name is [PII], and we're gonna use that in today's date as our reference. And so what is today the [PII] of, well, already April, yes, so we'll do that and that's gonna be our reference date. It's I know it's just flown by, hasn't it? OK. Well, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is, it is. 1st quarter is well gone.
[AGENT][POSITIVE] I know. Well, thank you for contacting us, [PII]. Anything else we can help with? Have, have a very good.
[CUSTOMER][POSITIVE] All right. Thank you, [PII], for your time.