AccountId: 011433970860
ContactId: 3b18c571-4410-434d-961d-889eb052eda7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 255839 ms
Total Talk Time (AGENT): 127956 ms
Total Talk Time (CUSTOMER): 80408 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/3b18c571-4410-434d-961d-889eb052eda7_20250404T17:16_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] over in AdMed Health, um, in [PII]. I just need eligibility on a patient.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], you're only meeting eligibility. You do not also need benefits, is that correct?
[CUSTOMER][NEUTRAL] Uh, yes ma'am, just eligibility.
[AGENT][NEUTRAL] You need
[AGENT][POSITIVE] OK, sure, I can help you with that. And what is a good call back number for you please, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] The policy number that I have is 01237685.
[AGENT][NEUTRAL] OK thank you one moment please.
[AGENT][NEUTRAL] Hey [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, her name is [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so something 012 or 37685. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's pulling up a different member.
[AGENT][NEUTRAL] Do you have a copy of her
[CUSTOMER][NEUTRAL] Well, the card, so OK, let me see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This, OK, the card they have scanned in, it says the insurance insured um person's name is [PII] is the holder.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on that card that's scanned in, give me that number again?
[CUSTOMER][NEUTRAL] Have
[AGENT][NEUTRAL] Can you see the
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I understood you to say [PII] instead of [PII]. So just one moment.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] What's the bathroom.
[CUSTOMER][NEUTRAL] How you want
[CUSTOMER][NEUTRAL] I thought you said what's the bathroom. I was like.
[CUSTOMER][POSITIVE] Um, I hope you use one.
[CUSTOMER][NEUTRAL] If you have and then we have to meet.
[CUSTOMER][NEGATIVE] It's a lot of issues.
[AGENT][NEUTRAL] OK, [PII], any information that I do provide for you will be a verification of benefits and not a guarantee of payment. Again, what is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so she is the spouse of the subscriber on the supplemental policy, [PII], and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And the correct policy number is 02137685.
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] Uh-huh, so yes, that is correct. Now, with this being a supplement to the primary insurance, if a claim is submitted to APL for review, we will have to have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then we do have our portals in which our claim status should be able to be checked once the claim has been processed by us by going to secured. [PII].
[CUSTOMER][NEUTRAL] OK, yes ma'am.
[AGENT][NEUTRAL] All right, well, is there anything else, [PII] that I can help you with today?
[CUSTOMER][POSITIVE] Um, no, ma'am, that was it. Thank you so much.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome and thank you for calling ATL. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Mhm.