AccountId: 011433970860
ContactId: 3c90bdb3-a78e-4310-aef9-7ade6b86abcf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203679 ms
Total Talk Time (AGENT): 68789 ms
Total Talk Time (CUSTOMER): 65768 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/3c90bdb3-a78e-4310-aef9-7ade6b86abcf_20241230T15:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Last name [PII] [PII].
[CUSTOMER][NEUTRAL] I needed to verify um patient eligibility and the network participation status please.
[AGENT][NEUTRAL] OK, I can barely hear you.
[CUSTOMER][NEUTRAL] Um, is that a little bit better?
[AGENT][NEUTRAL] That's better. Uh, so your first name you said is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And how can I help you?
[CUSTOMER][NEUTRAL] I need to verify patients eligibility and the network participation status please.
[AGENT][NEUTRAL] And participation within a network?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] I'm so sorry. Give me just one moment. I don't know where that went.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, got it. That's 019.
[CUSTOMER][NEUTRAL] 358
[CUSTOMER][NEUTRAL] 75
[CUSTOMER][NEUTRAL] M for Mary, L for Lima, and number 8.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 3 at the end.
[AGENT][POSITIVE] 3. OK, thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that information, [PII]. I show that the policy effective date is [PII].
[AGENT][NEUTRAL] I show the policy is active at this time.
[AGENT][NEUTRAL] And there is no uh network of providers for this policy.
[AGENT][NEUTRAL] So there, this policy is secondary to the major medical plan.
[CUSTOMER][NEUTRAL] OK, so we
[AGENT][NEUTRAL] And so we follow the primary insurance.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much. Is there any termination date for the plan?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is there any determination date for the plan?
[AGENT][NEUTRAL] Policy is active at this time.
[CUSTOMER][NEUTRAL] OK, got it. Thank you. Can I have your name and and the reference number?
[AGENT][NEUTRAL] You'll use my name and today's date as your reference for today's call. It's [PII].
[AGENT][NEUTRAL] ONYA.
[AGENT][NEUTRAL] First initial and last name is [PII] and any other questions, [PII]?
[CUSTOMER][NEUTRAL] Um, for the pre-certification requirements, that's also with the primary, right?
[AGENT][NEUTRAL] Uh, this policy does not require prior authorization.
[CUSTOMER][NEUTRAL] For anything
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] I don't know about the major medical. You would need to contact their, them to verify if it's required, but it's not for this policy.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] OK, got it thank you so much for your help.
[AGENT][POSITIVE] Alrighty, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.