AccountId: 011433970860
ContactId: 522f74f4-60c5-459b-bbc3-17285e1c37c0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347059 ms
Total Talk Time (AGENT): 135034 ms
Total Talk Time (CUSTOMER): 116403 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/522f74f4-60c5-459b-bbc3-17285e1c37c0_20250324T19:51_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]. My name is [PII]. I'm calling from provider's office regarding member eligibility.
[AGENT][NEUTRAL] OK, [PII], you're only needing to get eligibility for a member, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] Callback number will be [PII] [PII]. And [PII], may I know, does your name ends with an [PII] with [PII]?
[AGENT][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome and my name
[AGENT][NEUTRAL] What is the member's policy number?
[CUSTOMER][NEUTRAL] It's 125.
[CUSTOMER][NEUTRAL] 084
[CUSTOMER][NEUTRAL] 282
[AGENT][NEUTRAL] OK, now, [PII], that is going to be too long to be an APL policy number.
[CUSTOMER][NEUTRAL] Oh, unfortunately, [PII], I only have this ID number. If you don't mind, uh, could you please start with member's first name and last name?
[AGENT][NEUTRAL] OK, so you do not have an ID card?
[CUSTOMER][NEUTRAL] No, I don't have an ID card. Sorry for that.
[AGENT][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What is the last name?
[CUSTOMER][NEUTRAL] Last name is [PII]
[CUSTOMER][NEUTRAL] And the first name it's [PII], [PII] It's [PII].
[AGENT][NEUTRAL] And the first
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's going to take a few minutes to so.
[CUSTOMER][POSITIVE] Mhm. Sure, no problem. Take your time.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so I do not, does this number live in?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Sure, uh, no problem. Thank you so much for that. And, uh, [PII], the thing is I do have one more member to check for eligibility as well. Could you please also help me with that number?
[AGENT][NEUTRAL] Do you have the correct policy number for that number?
[CUSTOMER][NEUTRAL] For this one, I have the ID.
[CUSTOMER][NEUTRAL] Yes, I have.
[AGENT][NEUTRAL] OK, and what is that number, please?
[CUSTOMER][NEUTRAL] It's 02464806. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And your, any information that I do provide would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] My name will be [PII] with the date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. Now, the policy number that you gave me, it's not a valid policy number. Let me give you the correct policy number that you should have for this number.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the correct policy number is 2141679.
[AGENT][NEUTRAL] And just one moment. This policy is showing as active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for that.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And uh could you please provide me with the member's uh group ID number or group number?
[AGENT][NEUTRAL] Group number is 15493.
[CUSTOMER][NEUTRAL] Thank you. And it's a gap policy, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Thank you. And one last question. May I know whether the member [PII] is a subscriber or a dependent in the plan?
[AGENT][NEUTRAL] He is the subscriber.
[AGENT][NEUTRAL] And if you all will be filing a claim. You're welcome. And just a couple of things uh for you, [PII], if you will be filing a claim for him on this policy when the claim is submitted to APL, we must also have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][POSITIVE] Thank you so much for the confirmation, [PII]. Uh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And then once we have processed our claim, we have a portal you should be able to check claim status and that portal website is located at [PII].
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] OK. Thank you for that, [PII]. And uh that's all for today. May I have a reference number?
[AGENT][NEUTRAL] You're welcome. Uh, is there anything else?
[AGENT][POSITIVE] OK, the reference number would be my name and today's date. So again, if that's all I can help you with, thank you very much for calling APL and I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] Yeah, is there a reference number for our call?
[CUSTOMER][POSITIVE] Thank you so much for that.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.
[AGENT][POSITIVE] Oh, thank you. Bye bye.