AccountId: 011433970860
ContactId: 3f4a1965-6754-4f17-9e73-79b356c662a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288940 ms
Total Talk Time (AGENT): 132919 ms
Total Talk Time (CUSTOMER): 104852 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/3f4a1965-6754-4f17-9e73-79b356c662a9_20250314T14:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I'm [PII] Is Medical Enterprises. I need to check the eligibility for the patient.
[AGENT][NEUTRAL] OK, yes, I can check eligibility for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] It's [PII] Yeah.
[AGENT][NEUTRAL] That's that. OK.
[AGENT][POSITIVE] Got it thank you and then uh can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah. It's [PII].
[AGENT][NEUTRAL] OK, thank you and then did you have the policy number?
[CUSTOMER][NEUTRAL] Yeah. It's 02201828MLH.
[AGENT][NEUTRAL] OK and uh what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Yeah. It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. Uh, so this policy is active. Uh, when was the effective date was his birthday, so [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] Yeah. May I know the effective date?
[AGENT][NEUTRAL] The effective date for [PII] was his birthday, um, but for the policy holder, the effective date was [PII].
[CUSTOMER][NEUTRAL] Yeah, is there a any group number?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Group number?
[AGENT][NEUTRAL] Uh, yes, just a moment. That group number is 21746.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's a commercial plan?
[AGENT][NEUTRAL] It is through their employer.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Yes, it is through their employer.
[CUSTOMER][NEUTRAL] Yeah. May I know the plan type that is EPO HMO PPO?
[AGENT][NEUTRAL] Uh, nothing like that. So as it's a secondary medical policy, it is heavily dependent on major medical. So if major medical is willing to pay, then this policy can. If major medical does not, this policy can't.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Can I have the policyholder detail?
[AGENT][NEUTRAL] Uh, the policy holder is [PII].
[CUSTOMER][NEUTRAL] Oh, OK. And the date of birth of the policyholder?
[AGENT][NEUTRAL] Um, I'm not able to give that information out.
[CUSTOMER][NEUTRAL] OK, I have the data. Can you check it that the data is correct or not?
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Yeah. It's uh [PII]. Am I right?
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And the providers, may I know the provider network of our network?
[AGENT][NEUTRAL] What was that? I'm sorry?
[CUSTOMER][NEUTRAL] Yeah. May I know the providers in-network or off-network for American public life?
[AGENT][NEUTRAL] Again, this is not affiliated with any networks. It is dependent on major medical as long as her major medical is willing to pay this policy can if her major medical does not pay, this policy can't.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. OK. Can I have the same mailing address?
[AGENT][NEUTRAL] Yes, uh, that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] And I've also got a uh fax number and a payer ID if you'd like.
[CUSTOMER][NEUTRAL] Can I have a
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I want the electronic period.
[AGENT][NEUTRAL] Just the payer ID?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, that's uh 60801.
[CUSTOMER][NEUTRAL] OK, thank you. Uh, the accounting pay ID is 60801. Am I right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, can I have your name and the last name insured?
[AGENT][NEUTRAL] Yes, uh, my name is spelled [PII] Was there anything else I could help you with [PII]?
[CUSTOMER][NEUTRAL] Yeah, I just need a reference number participation.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial and today's date.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you. OK.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] No, thank you, bye bye.
[AGENT][POSITIVE] Thank you bye bye.