AccountId: 011433970860
ContactId: 4166c499-f21a-4c24-938c-d32214d7af9b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243039 ms
Total Talk Time (AGENT): 101485 ms
Total Talk Time (CUSTOMER): 94448 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/4166c499-f21a-4c24-938c-d32214d7af9b_20250502T21:26_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from Anthem Blue Cross Blue Shield. I was just looking to verify coverage for one of your members.
[AGENT][POSITIVE] OK, well, I can definitely help you with the eligibility and benefits. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, area code [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02287977
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII] birth date [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Well, um, I, I really didn't need any benefit in except for, uh, to know if he has a pharmacy coverage under the plan.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There's no um pharmacy coverage under this policy.
[CUSTOMER][NEUTRAL] No, is there anyone else on the plan, uh, like a spouse?
[AGENT][NEUTRAL] Oh I see.
[AGENT][NEUTRAL] Um, I am showing the spouse on the policy as well.
[CUSTOMER][NEUTRAL] OK, I have uh [PII].
[CUSTOMER][NEUTRAL] Lamb birth date, I think let me double check that sometimes last names aren't the same.
[CUSTOMER][NEUTRAL] Yeah, [PII] Lamb, uh, birth date.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is, um, hold on one second, a verification of benefits, not a guarantee of payment, and yes, she's on this policy as well. Um, the date of birth is correct also.
[CUSTOMER][NEUTRAL] OK, uh, you mean the [PII] is the same for her?
[CUSTOMER][NEUTRAL] The effective date
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and you guys do coordinate right with other like he has, um, just to verify he has coverage with us under a small group but it's an employer group uh and you guys coordinate benefits with other coverage.
[AGENT][NEUTRAL] Right, so this policy is 2nd. Let me make sure it flips over. Hold on one second.
[AGENT][NEUTRAL] This policy is second to their Anthem Blue Cross Blue Shield only, so, um, we pay towards the co-pay, deductible and co-insurance after their primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, did you guys, it's because of the longer shorter rule because his anthem policy was in effect before yours.
[CUSTOMER][NEUTRAL] Is that what you guys do? I know that's what we do if they, you know.
[AGENT][NEUTRAL] No, so it's.
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] No, it's OK. Um, the policy is through the employer, so they just, they're just grouped together. Um, we just work at, that's who the employer chose for primary, so we just work after them, um, but only up to their calendar year max.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got you. OK, uh, do you have a reference number for our call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, and again that's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK great thank you [PII]. I appreciate it.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] You too you too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.