AccountId: 011433970860
ContactId: 5bab3fcf-b327-4fc2-b929-886aabd01572
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 759150 ms
Total Talk Time (AGENT): 150665 ms
Total Talk Time (CUSTOMER): 431212 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/5bab3fcf-b327-4fc2-b929-886aabd01572_20250508T14:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. My name is [PII]. We're the provider calling for outpatient eligibility and benefits.
[AGENT][NEUTRAL] OK, well, I can help you with both the eligibility and benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yeah, OK. Uh, [PII], I'm sorry, you want my phone number, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number whenever you're ready.
[CUSTOMER][NEUTRAL] OK, hold on one second, I'm just double checking something.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sorry, just checking something here.
[CUSTOMER][NEUTRAL] OK, because I think, hold on, I'm just checking something if you don't mind for one second because we have a couple American public if you don't mind, just I'm just sorry, just checking something quickly. This is American public. We have you guys are very popular.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] be one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm just seeing, was this one American Pub Life? I always forget. Yes, OK, can we do two American Pub Life?
[AGENT][NEUTRAL] Like 2 policies?
[CUSTOMER][NEUTRAL] Yes, is that OK?
[AGENT][NEUTRAL] Oh, yes, that's fine.
[CUSTOMER][NEUTRAL] OK, so the first one, OK, so let me mark this one down too so that way we can do both. OK, so the first one policy number is gonna be, let me see here.
[CUSTOMER][NEUTRAL] Um, OK. Uh, 01659321 ML.
[AGENT][NEUTRAL] All right. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I'm actually showing on this particular policy is no longer active. It was effective from [PII].
[CUSTOMER][NEUTRAL] Ah
[AGENT][NEUTRAL] Um, they did have a policy.
[CUSTOMER][NEUTRAL] OK, it it
[CUSTOMER][NEUTRAL] Is there anything else with you guys?
[AGENT][NEUTRAL] They did have a policy, um, policy number 2502649.
[AGENT][NEUTRAL] That was their most recent policy, which is also not active. Um it was effective from [PII]. So they do not have an active policy with APL.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] 00, yeah I'm looking at, OK, I'm blind. I'm sorry, so I'm not, I'm not focused, so their, their data service was [PII].
[CUSTOMER][NEUTRAL] So was she good for that date of service right?
[AGENT][NEUTRAL] So are you needing a claim status or eligibility?
[CUSTOMER][NEUTRAL] Eligibility status.
[AGENT][NEUTRAL] For a date of service. You're wanting to see if a policy was active on a date of service?
[CUSTOMER][NEUTRAL] For that data service.
[CUSTOMER][NEUTRAL] Yes, but that's, yes, I'm so sorry. I'm on that digging straight. [PII].
[AGENT][NEUTRAL] What's your date of service?
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So, at that, on that date of service, the policy that was active is the policy number you gave.
[AGENT][NEUTRAL] The 1659321.
[CUSTOMER][NEUTRAL] OK, so it was OK.
[CUSTOMER][NEUTRAL] OK, perfect. So that was active during that time. OK, perfect. Sorry, I wasn't, I wasn't clear. OK, and what, what at that time, what, what was the group group name and group number, [PII]?
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] The group number is 15493.
[CUSTOMER][NEUTRAL] Hold on one
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And the group name is City.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]? OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] H I A L E A H. OK, perfect.
[CUSTOMER][NEUTRAL] OK, let me go ahead and save this save this one, and then we'll go on to the next one. Just give me one second. I'm sorry I didn't.
[CUSTOMER][NEUTRAL] And you're [PII] or [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, reference number is gonna be A and then A.
[CUSTOMER][NEUTRAL] 0508 2025. OK, one second, let me go ahead and save this, OK.
[CUSTOMER][NEUTRAL] OK, and the father is the subscriber, right? [PII]?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, let me add him.
[CUSTOMER][POSITIVE] OK, perfect. And then we're as a father.
[CUSTOMER][POSITIVE] OK, perfect. So now at that time they.
[CUSTOMER][POSITIVE] OK, perfect. And how's your day going today? Good?
[AGENT][POSITIVE] It's going good. How's yours?
[CUSTOMER][POSITIVE] It's going OK.
[CUSTOMER][NEGATIVE] You know, it's, it's funny. I don't know. I had people like they work with and it's like they're working on something else and then it's like they don't tell you and they don't, they don't, they don't tell you. And it's like, OK, but then they're supposed to be helping you, it's like, OK, that's rude.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know, have you ever, have you ever had that before?
[AGENT][NEUTRAL] Yeah, I have.
[CUSTOMER][NEGATIVE] So today I told the guy I'm like, listen, please let me know because we work we work on the same list. Please let me know when you're ready for me to grant access and he goes, OK, just did. I feel like saying to myself, you know, it's like I'm like telling myself and I know like I've been granting him access and he hasn't been helping me so I just like saying screw it if he doesn't, if he doesn't ask and then I don't wanna grant him access, you know what I'm saying? I just feel like, you know.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] If he's not, you know, and, and every time I would say grant them access to the list and then he's barely helping me.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I felt like saying oh we're a team we need to communicate but I'm like oh maybe that's I don't wanna, you know.
[CUSTOMER][NEUTRAL] Uh, verified admin through HDX, um.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] With rep name, uh, hold on, it's my phone on silent. My ring is on my phone, so coordinate rep name in there by APL, a gap plan active on DOS.
[CUSTOMER][POSITIVE] OK, perfect. Let me see and I'll go to the next one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. I'm gonna make sure this is good.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, 2024, a long time ago.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ana, oh, I put admin.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this is a gap plan, right?
[CUSTOMER][NEUTRAL] And they, I, I'm sorry, I forgot to ask. I forgot to ask, they do have that urgent care coverage, right? Did I ask that?
[AGENT][NEUTRAL] Um, yes, that's.
[AGENT][NEUTRAL] No, you didn't. Um, let me take a look and see. Hold on one moment.
[CUSTOMER][NEUTRAL] Sorry, I'm not, I don't know why my mind is not.
[CUSTOMER][NEUTRAL] Thinking straight.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] It's OK. Um, so,
[AGENT][NEUTRAL] Under outpatient, yes, there's urgent care coverage under outpatient.
[CUSTOMER][POSITIVE] OK, perfect. OK, got you, perfect. Now let me save this and go on to the next one.
[CUSTOMER][NEUTRAL] OK, so let me
[CUSTOMER][NEUTRAL] OK so let me see.
[CUSTOMER][NEUTRAL] OK, let me go on to the next one it's loading.
[CUSTOMER][NEUTRAL] OK, uh, it didn't go through.
[CUSTOMER][NEUTRAL] OK, so the next one, her policy number is gonna be um 01797926 MLA.
[AGENT][NEUTRAL] All right. And are you wanting to know if a data service is active on a
[AGENT][NEUTRAL] On a policy?
[CUSTOMER][NEUTRAL] Yes, OK, so this is, this is 221, I mean [PII], so this is current.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you for that and
[AGENT][NEUTRAL] For [PII], this is the correct policy, on the 179-7926.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, hold on one second, I'm just double checking something.
[CUSTOMER][NEUTRAL] Hold on, just double checking.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, I'm just looking at something on her card or something, one second.
[CUSTOMER][NEUTRAL] Signa OK.
[CUSTOMER][NEUTRAL] OK. And OK, so she does have urgent care coverage?
[AGENT][NEUTRAL] Yes, under outpatient.
[CUSTOMER][POSITIVE] OK, hold on, perfect let me update something.
[CUSTOMER][NEUTRAL] 48
[CUSTOMER][POSITIVE] 37. OK, perfect.
[CUSTOMER][POSITIVE] It's funny for like so and so for her primary, her primary signa. So I've learned like for the addresses what goes to what so that way it gets built properly.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Because if you leave the wrong billing address in the system.
[CUSTOMER][NEUTRAL] You know,
[AGENT][NEUTRAL] Are we going to the wrong place.
[CUSTOMER][NEGATIVE] OK, that's not good.
[CUSTOMER][NEUTRAL] Ah
[CUSTOMER][NEUTRAL] Oh hold on one second. What happened there?
[CUSTOMER][NEGATIVE] Oh no, hold on, let me, let me try something again. One second, my system just froze. 1 2nd.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] 15. And
[CUSTOMER][NEGATIVE] I do need to fix this.
[CUSTOMER][NEUTRAL] 188061. OK. Perfect. OK. And safe. OK, and she's active? OK, perfect. So let me make a note of that.
[CUSTOMER][NEUTRAL] OK, what is the group group name gonna be Anna?
[AGENT][NEUTRAL] The group name is Jetstream Federal Credit Union.
[CUSTOMER][NEUTRAL] Jetstream Federal.
[CUSTOMER][NEUTRAL] Credit Union? OK.
[CUSTOMER][NEUTRAL] U N I O N and the group number is 68081.
[AGENT][NEUTRAL] No, the group number is 17675.
[CUSTOMER][NEUTRAL] 17675 OK perfect um my system's all all my stuff is not organized. OK, hold on.
[CUSTOMER][NEUTRAL] OK, so let me go ahead.
[CUSTOMER][NEUTRAL] And then [PII] and her mother's subscriber, [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so let me add the other subscribers, one second. So the current.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Yeah add all that.
[CUSTOMER][NEUTRAL] OK, let me do another for the one.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I think cooking relationship.
[CUSTOMER][NEUTRAL] Why does it keep doing that? The address keeps changing for Cigna. I don't know why. 188061.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, there we go.
[CUSTOMER][NEGATIVE] He does not like me today.
[CUSTOMER][POSITIVE] OK, there we go. OK, perfect. OK. And they have the outpatient coverage. OK, perfect. And your name and today's date. All right, thanks, [PII]. I appreciate you. Have a good have a good day.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You're welcome, [PII].
[AGENT][POSITIVE] You too. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, not right now. Thank you.
[AGENT][POSITIVE] All right, you're welcome. Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye-bye.