AccountId: 011433970860
ContactId: 5642e579-67cb-49a5-a906-71c987fd3fbc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 603219 ms
Total Talk Time (AGENT): 118505 ms
Total Talk Time (CUSTOMER): 255012 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/5642e579-67cb-49a5-a906-71c987fd3fbc_20250623T16:09_UTC.wav
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[AGENT][NEUTRAL] For calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I just want to check the eligibility of the patient. Can you please help me with that?
[AGENT][POSITIVE] Yes [PII], I can help you with eligibility. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, policy number is, uh,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I still.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Uh, not one of our policy numbers. Do you have the last name of the patient?
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, the patient's first name is
[CUSTOMER][NEUTRAL] Uh [PII], it is [PII] last name [PII] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 35.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and the first name was, how do you spell the first name?
[CUSTOMER][NEUTRAL] Uh, first name is, uh,
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. Um, let's see.
[AGENT][NEUTRAL] I'm not pulling up that name. Do you have a number by chance?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Uh, this is the one I have, ma'am.
[AGENT][NEUTRAL] OK. I'm not able to locate the patient with the information that's been provided.
[CUSTOMER][NEUTRAL] OK. Got it. Give me a moment and we'll move to the next one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I need some information about you.
[CUSTOMER][NEUTRAL] Like, can you spell it?
[CUSTOMER][NEUTRAL] Oh my God.
[AGENT][NEUTRAL] Spell my name.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes, give me a moment, ma'am.
[CUSTOMER][NEUTRAL] And we'll move to the next one, unable to find the payer. Can you spell your name?
[CUSTOMER][NEUTRAL] 3.
[AGENT][NEUTRAL] Yes, it's [PII]. It's [PII]
[CUSTOMER][NEUTRAL] [PII]. OK. We'll move to the next one.
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I don't know about that.
[CUSTOMER][NEUTRAL] Give us a
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You have the policy number?
[CUSTOMER][NEUTRAL] 0259584001.
[CUSTOMER][NEUTRAL] Did.
[CUSTOMER][NEUTRAL] I don't.
[AGENT][NEUTRAL] That was 025984.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, it is.
[CUSTOMER][NEUTRAL] 0259584001.
[AGENT][NEUTRAL] OK, uh, our policy numbers will range from 6 digits to 8 digits.
[AGENT][NEUTRAL] So do you have the last?
[CUSTOMER][NEUTRAL] Go with the member name, ma'am.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Go with the member name.
[AGENT][NEUTRAL] I don't know the member name. Do you have it?
[CUSTOMER][NEUTRAL] Yes. Uh it is Y O S E F Y O S E F and the last name is [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, that
[CUSTOMER][NEGATIVE] Unable to find any information?
[AGENT][NEUTRAL] Uh, I'm still working on it. Let me see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] I'm to him.
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] OK, that's it. And do you have the date of birth for the patient?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Are you sure the policy is active and effective [PII]?
[CUSTOMER][NEUTRAL] 3.
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much. And uh can you please provide me the correct payer ID number?
[AGENT][NEUTRAL] Um, do you want the policy number?
[CUSTOMER][NEUTRAL] Pay ID number. Afterwards I need policy.
[AGENT][NEUTRAL] Your ID is 60801.
[CUSTOMER][NEUTRAL] 60801. Patient group number?
[AGENT][NEUTRAL] Group number 18027.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 18027.
[CUSTOMER][NEUTRAL] Correct, uh, give me a moment, ma'am. Correct mailing address?
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much, ma'am. And uh
[CUSTOMER][NEUTRAL] Can you please uh
[CUSTOMER][NEUTRAL] And you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] A patient has remaining deductible amount.
[AGENT][NEUTRAL] Are you needing any benefits?
[CUSTOMER][NEUTRAL] Yeah, I just need uh uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And this is not a guarantee of payment based outline of the policy.
[AGENT][NEUTRAL] Um, is this for inpatient or outpatient?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can you just uh check the inpatient.
[CUSTOMER][NEUTRAL] Hey, I hear nothing visible.
[AGENT][NEUTRAL] Inpatient? OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You should not
[AGENT][NEUTRAL] Um, for their inpatient benefits, just a second.
[CUSTOMER][NEUTRAL] Provide the member ID ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, inpatient, they have a $5000 benefit, not a deductible, that's what we pay.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Can you please provide me the correct mailing address?
[AGENT][NEUTRAL] Mailing address?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The one that I just gave you, [PII]. OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Not telling uh, no, sorry, sorry, sorry, ma'am. Sorry ma'am. The member ID number.
[AGENT][NEUTRAL] 259-584-0
[CUSTOMER][NEUTRAL] 259-584-0
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That's it?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 59,840.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Do, do you need any other information?
[CUSTOMER][POSITIVE] Mm, no, ma'am. Thank you, [PII]. Have a nice day. Bye-bye.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you for calling APL. You too. Bye-bye.