AccountId: 011433970860
ContactId: 570f7f94-d0ea-49bd-b3f1-5be17277eb6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275079 ms
Total Talk Time (AGENT): 93365 ms
Total Talk Time (CUSTOMER): 133476 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/570f7f94-d0ea-49bd-b3f1-5be17277eb6c_20250505T20:28_UTC.wav
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[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, good afternoon, [PII]. My name is [PII]. I'm calling from Novo Health South Park Breast Clinic, and I'm calling to see if the, um, for eligibility for a patient that's having a, a mammogram 3D tomo additional view at our, um, Novo Health um breast clinic, um, facility.
[AGENT][NEUTRAL] OK. Well, I can definitely help you with the eligibility and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, the contact number is gonna be [PII] and um please use option one. This is a group number that if you call in anyone can answer your calls to avoid um you being transferred to different departments, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and I'm sorry, you said your name again. I'm bad with names. I have so many per day to come by. I'm sorry, you said your name?
[AGENT][NEUTRAL] It's all right. My name is [PII].
[CUSTOMER][POSITIVE] OK, [PII]. Thank you, [PII].
[AGENT][NEUTRAL] You're welcome. And then just the um policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I have the subscriber ID numbers being 01836552 M as in Mary, [PII] as in Larry [PII].
[AGENT][NEUTRAL] All right. And can you verify the member's um first and last name and date of birth?
[CUSTOMER][NEUTRAL] [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. So I am showing that this policy is no longer active. Um, it was effective from [PII], I'm sorry, to [PII], but they do have an active policy number. Let me get that for you.
[CUSTOMER][NEUTRAL] OK, when you say active policy number because I do have one that she, um, does she have Aetna? Are you talking about a different plan?
[AGENT][NEUTRAL] Um, so, um, hold on, let me pull it up so I can see if it's, well, no, we're not Aetna, we would, we could possibly be second to them. I'm pulling it up now.
[CUSTOMER][NEUTRAL] OK, that's why I have generic commercial general pub, um.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Commercial, so it's supposed to be secondary to Aetna.
[AGENT][NEUTRAL] OK, yeah, so.
[AGENT][NEUTRAL] Yes, so Aetna is primary and this policy is secondary. Um, let me give you the policy number.
[CUSTOMER][NEUTRAL] OK, so it is active then. Is that correct?
[AGENT][NEUTRAL] The policy number that you gave me is not active. The policy number I'm getting ready to give you is.
[CUSTOMER][NEUTRAL] OK, one moment, let me get this so I can put that in real quick. OK, could you give me the policy number, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's 255.
[AGENT][NEUTRAL] 6039.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2556039, that's the policy. OK, let me come out of it and let me go and run it again.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Let's say 2.
[CUSTOMER][NEUTRAL] run it again.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] 2556039. OK, I'm getting ready to run it again because it's.
[CUSTOMER][NEUTRAL] OK, is there this, this telling just the policy just now we would call this a subscriber ID number. Would that be the same one and the same?
[AGENT][NEUTRAL] Um, it can be subscriber ID number, policy number, it's all the same.
[CUSTOMER][NEUTRAL] OK, so when they are eligible for this one, this is the new one, OK, so I'll go ahead and note the account, um, that it is, um, da da that that it is active, um.
[CUSTOMER][NEUTRAL] [PII], do you have a reference number, [PII]?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you. OK, today's day 55, [PII]. Thank you, [PII]. Have a great day and you, bye for now.
[AGENT][POSITIVE] You're welcome, [PII]. And was there anything else I can help with?
[CUSTOMER][POSITIVE] No, that'll be it. Thank you so much.
[AGENT][POSITIVE] Alright well thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] OK, you too.
[AGENT][POSITIVE] Thank you. Bye bye.