AccountId: 011433970860
ContactId: 39e614ee-4b52-48a7-bc5b-38d5a3ebf339
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 616890 ms
Total Talk Time (AGENT): 156209 ms
Total Talk Time (CUSTOMER): 96893 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/39e614ee-4b52-48a7-bc5b-38d5a3ebf339_20250610T15:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey, how's it going? I'm, I'm a provider and I'm calling just to verify this patient's gap insurance.
[AGENT][NEUTRAL] OK, I can verify eligibility and or benefits for you. And your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and what is that policy number, please?
[CUSTOMER][NEUTRAL] OK, so there's.
[CUSTOMER][NEUTRAL] So I'm gonna give you the one that I need because it's the in-hospital benefit card number. Is that the one? Is that one OK?
[AGENT][NEUTRAL] Oh, that's fine, yes.
[CUSTOMER][NEUTRAL] 02258742 ML 7.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] I do not show them under this policy number. You said it's 2258742?
[CUSTOMER][NEUTRAL] 2258742 do you see [PII]?
[AGENT][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] OK, so that's the card he gave me. He said it was covered under, he said his family's in the coverage.
[AGENT][NEUTRAL] OK. And I do show family coverage, but I don't show that patient in our system. Um, what he can do, give me one moment.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Um, the insurer can contact their employer, so they can send us information to have that, um, dependent added.
[AGENT][NEUTRAL] Or a claim can be submitted and usually if it's family coverage, they can just have them added onto the plan.
[AGENT][NEUTRAL] Since it shows his family, they will verify with the employer, but um either y'all can submit a claim and they can have a person added if it's family coverage and they can verify with the employer or the insurer can contact their employer, let them know that this dependent was not added onto the plan, and they can send us information to have them added.
[CUSTOMER][NEUTRAL] Still right?
[CUSTOMER][NEUTRAL] OK, so right now [PII]'s family plan has no dependent on it.
[AGENT][NEUTRAL] No, it has dependent. It just doesn't have that person on the plan that you're inquiring about. That's what I'm saying that he can contact his employer, let them know that this dependent wasn't added onto the plan, and they can send us information to have him added. But from what I see, he is on the plan and it shows dependent spouse, but because it is a family coverage. I just don't show that person on the plan.
[CUSTOMER][NEUTRAL] So [PII] is not on the plan.
[AGENT][NEGATIVE] It's not showing correct.
[CUSTOMER][NEUTRAL] On the plan.
[CUSTOMER][NEUTRAL] So then his course of action is contacting his employer to add her.
[AGENT][NEUTRAL] He can contact his employer and they can, his employer can contact our office to have them at her.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] But let me double check one moment.
[CUSTOMER][NEUTRAL] Yeah, cause they're currently, well, she's about to give birth.
[CUSTOMER][NEUTRAL] And I.
[CUSTOMER][NEUTRAL] This is pretty big if he has a gap in or not.
[CUSTOMER][POSITIVE] It'll help the coverage.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] So I'm assuming that it's a spouse?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, OK, let's see it well.
[AGENT][NEUTRAL] Especially when I see it's a, you know, they would, um.
[AGENT][NEUTRAL] Let me see where customer service. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK. I'm gonna put you on a quick hold. I have a call coming.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah, hello?
[AGENT][NEUTRAL] Uh, yes, sir. I was just told that the patient is just not listed on the plan, but um, I would assume the insured should contact their employer so they can get in contact with our customer service department because it's just.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Not showing that patient is under the plan.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] OK, uh, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, uh, yeah, can I have your, your name and a reference number?
[AGENT][NEUTRAL] Sure. My name is [PII], last initial [PII], and as far as reference, you may use my name at today's date.
[CUSTOMER][NEUTRAL] GQQ
[CUSTOMER][POSITIVE] [PII]. Alright, sounds good thank you so much for your time, OK?
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Alright you too bye.
[AGENT][NEUTRAL] Bye.