AccountId: 011433970860
ContactId: 59642755-3139-46e1-88af-50eb04554464
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198830 ms
Total Talk Time (AGENT): 106759 ms
Total Talk Time (CUSTOMER): 55713 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/59642755-3139-46e1-88af-50eb04554464_20250410T17:44_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, I'm calling so I can verify a member's um eligibility.
[AGENT][NEUTRAL] OK, you're only needing eligibility. You do not need benefits. Is that correct?
[CUSTOMER][POSITIVE] Mm correct.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm so sorry, did you say [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] OK, [PII], thank you. And your callback number, please?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number [PII].
[CUSTOMER][NEUTRAL] It is going to be.
[CUSTOMER][NEUTRAL] 01843.
[CUSTOMER][NEUTRAL] 884 ML 8
[AGENT][NEUTRAL] OK, [PII], thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And again, [PII], you did say you were only needing eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, I can help you with that and any information that I provide would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] It's gonna be for Roger Ubina and their date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so I do show that he is a dependent on the supplemental policy, Kiana, and the policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Now if you can if there's a way that you can make a note since you're only checking eligibility but if a claim is going to be filed with APL for this member, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal that you should be able to check claim status in.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the website for our portal is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK perfect [PII].
[AGENT][POSITIVE] All right. Yes, ma'am, [PII]. You're welcome. And is there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] Is there gonna be a reference number for this call or do I use your name?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much have a great day.
[AGENT][POSITIVE] All right. Well, well, I hope you have a great day too, and thank you again for calling APL if that's all I can help you with.
[CUSTOMER][POSITIVE] Perfect thank you so much bye bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.