AccountId: 011433970860
ContactId: 4f6a2d98-5fa7-497e-9ef5-06b47b3f6a74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285739 ms
Total Talk Time (AGENT): 91516 ms
Total Talk Time (CUSTOMER): 136420 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/4f6a2d98-5fa7-497e-9ef5-06b47b3f6a74_20250224T15:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII], and I have a a letter of an eligibility denial. I was hoping maybe you could help me with that.
[AGENT][NEUTRAL] Sure, um, and [PII], are you calling with the provider's office or you're the insured?
[CUSTOMER][NEUTRAL] I'm from the provider's office.
[AGENT][NEUTRAL] OK, may I have the contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] Of course. Uh, my number is [PII] is a direct line. The member's number is Delta 45400284.
[AGENT][NEUTRAL] OK, and do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] I do. I just, I had to look at that just to get your, your phone number. So it's pulling up. So yes, I've got the copy of the card up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, do you see where it says in hospitals or outpatient policy cert number?
[CUSTOMER][NEUTRAL] Inpatient.
[AGENT][NEUTRAL] Or it may just say policy certification number. It should start with a 01 or 02.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I see a policy certification number.
[AGENT][NEUTRAL] OK, yes.
[CUSTOMER][NEUTRAL] That looks like 01863350.
[AGENT][NEUTRAL] Thank you. Hold on one moment. So that, that's the um policy number 63,350.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Is that their ID number?
[AGENT][NEUTRAL] Yes, that's their policy number.
[CUSTOMER][NEUTRAL] OK. So we have that in.
[AGENT][NEUTRAL] And can you verify?
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] So, so from the very beginning, we at least have that incorrect. Oh no. It says medical ID number.
[AGENT][NEUTRAL] Yes, the the number is 4.
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] The the number that you gave us for 90 degree benefits, that's on the card also, it's just we're two different companies, so uh the policy service is ours.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So I need to have the policy number and not the medical ID number for
[AGENT][NEUTRAL] APL, right.
[CUSTOMER][NEUTRAL] OK, so that's 01863350.
[CUSTOMER][NEUTRAL] OK, so I can at least correct that, and then if you could by any chance tell me if they have active coverage.
[AGENT][NEUTRAL] Oh let's
[AGENT][NEUTRAL] Um, can you first verify her first and last name and date of birth?
[CUSTOMER][NEUTRAL] Of course, I have [PII]. Her date of birth is [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].
[CUSTOMER][NEUTRAL] Perfect. So I just need to correct the ID number that I have and reset resubmit a claim.
[AGENT][NEUTRAL] Right. Mhm.
[CUSTOMER][POSITIVE] Perfect. OK, let me get back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, the coffee hasn't hit my fingers yet.
[AGENT][NEUTRAL] And [PII], was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK, my dear.
[CUSTOMER][NEUTRAL] No, that'll do it at the moment. So it, it, can I get a reference number, hon?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date.
[CUSTOMER][NEUTRAL] OK, so [PII] and today's date is?
[AGENT][NEUTRAL] Yes, and the first
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] The first initial to my last name is [PII], and today's date is [PII].
[CUSTOMER][NEUTRAL] And the first initial of your last name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How, how did we already get to the end of February already.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][POSITIVE] OK, sweetie, I'm gonna let you go help somebody else that needs your expert help.
[AGENT][POSITIVE] Oh, thank you. Well, thanks for calling [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. Thank you, my dear. You too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.