AccountId: 011433970860
ContactId: 574a6572-3193-4b2b-baa7-0cb861f09c6f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298359 ms
Total Talk Time (AGENT): 119737 ms
Total Talk Time (CUSTOMER): 129270 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/574a6572-3193-4b2b-baa7-0cb861f09c6f_20250606T17:54_UTC.wav
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[CUSTOMER][NEUTRAL] I go.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, this is uh about this uh health primary care provider's office calling in regards to a mutual patient.
[AGENT][NEUTRAL] OK, are we just needing to check uh eligibility?
[CUSTOMER][NEUTRAL] Um, in a sense, yes, but also now at the same time, because I did run the insurance and it does show that it is active, but I am having quite a bit of an issue with it. Um, I am running the patient's insurance and it is showing that the PCP is Chiappone detain.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And the patient is a patient of
[CUSTOMER][NEUTRAL] Let me just look at it here.
[CUSTOMER][NEUTRAL] A patient of Dr. [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know if that's something that we can go ahead and change so we can correct it.
[AGENT][NEUTRAL] Um, that would not be through me. Um, we provide supplemental coverage, so whatever policy, whatever medical policy they have with us would either be, um, a secondary medical or um a limited indemnity plan. So we, they could potentially take those plans anywhere. We don't keep record of who they have as their primary or anything like that.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, I mean, the reason why this is the number that I called is when I look under the patients, um, Admet insurance, it does populate this number for eligibility and, um, authorizations, which usually we call this number to go ahead and see if the PCP can change.
[AGENT][NEUTRAL] No authorization is.
[AGENT][NEUTRAL] OK, um, what number did you dial?
[CUSTOMER][NEUTRAL] 1800.
[CUSTOMER][NEUTRAL] 256-860-6
[AGENT][NEUTRAL] OK, yeah, that is us, um.
[AGENT][NEUTRAL] Let's go ahead and get their policy pulled up just so we can see um what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] option 5.
[AGENT][NEUTRAL] OK, thank you. uh, do you have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, I do. It does start with the letter which is A 600699-0300.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that is not one of our policy numbers, [PII], um, none of our policies start with the letter A and that is a bit too long. Um, do you maybe have their social? I could search for them that way.
[CUSTOMER][NEUTRAL] Oh, that one might be a little bit harder to find, but hold on, give me one second.
[AGENT][NEUTRAL] Sure, only other way I'd be able to search is if you wouldn't mind um spelling out their first and last name.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] First name is going to be [PII], which is [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] The Last name is [PII], [PII]
[AGENT][NEUTRAL] OK, give me just a moment, let me see, uh, what state does this member live in?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Specifically, uh.
[AGENT][NEUTRAL] Uh-huh, go ahead.
[CUSTOMER][NEUTRAL] Specifically region of [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Let's see, I've got.
[AGENT][NEUTRAL] A couple season [PII] um.
[AGENT][NEUTRAL] I've got Gulf tour, uh, Pembroke Pines. I'm not really familiar with cities around there. Um, let's see, let's try this one. yes, if you wouldn't mind giving me her date of birth.
[CUSTOMER][NEUTRAL] Would you need date of birth as well?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, here we go. I think I did find her. Let's see.
[AGENT][NEUTRAL] OK, so I did find her, however, she does not have any active policies with us. Uh, the last policy she had was a secondary medical and that terminated [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] This is striking me as odd.
[AGENT][NEUTRAL] It does seem like an odd situation.
[CUSTOMER][NEUTRAL] Very, very, very, very, and obviously them putting this number as the authorization number.
[CUSTOMER][NEUTRAL] I would think that this would be the line, but I'm guessing not.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] No, and I mean I did try to contact the patient first to see what she did would advise, but she didn't answer.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Um, alrighty, uh, I'll do my best to try and figure it out, try to, no, no, no, it's OK. You did your best.
[AGENT][POSITIVE] OK, I'm so sorry. I wish there's more I could do to help.
[AGENT][POSITIVE] All right well I appreciate you giving us a call. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too ma'am enjoy a great weekend.
[AGENT][POSITIVE] Thank you. You too, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.