AccountId: 011433970860
ContactId: 5da88c9d-41a0-4a14-841b-be69a73da503
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251309 ms
Total Talk Time (AGENT): 134641 ms
Total Talk Time (CUSTOMER): 48894 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/5da88c9d-41a0-4a14-841b-be69a73da503_20250306T21:43_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] Hello [PII], I'm calling to get eligibility on a patient.
[AGENT][NEUTRAL] OK, you only need eligibility, you do not need benefit information, is that correct?
[CUSTOMER][POSITIVE] Yes, ma'am, that is correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] 02460661
[AGENT][NEUTRAL] OK, thank you. Give me one moment to sure to get this information pulled up please.
[AGENT][NEUTRAL] And any information that is provided today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this policy and again initiating the information I provide will be a verification of benefits and not a guarantee of payment. The supplemental policy is active.
[AGENT][NEUTRAL] And the effective date on the plan is [PII].
[CUSTOMER][NEUTRAL] OK. And is there a call refer go ahead.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] 00, I'm sorry, I was just gonna give you a couple of additional pieces of information because this is a supplemental policy to as primary insurance. If you all file a claim to APL, we will also need to receive a copy of its primary insurance explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed the claim here we do have a portal that you should be able to check our claim status and have access to our EOB by going to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And as far as your call reference number, [PII], you would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK, and just to reiterate, you said we're processing claims, we need to submit the EOB and what else?
[AGENT][NEUTRAL] This is a supplemental policy to his primary insurance. So when the claim is filed with APL for review, you will need to include a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm just typing what you stated.
[AGENT][POSITIVE] OK. Uh, OK. I just wanted to make sure you got on my end, the line got exceptionally quiet, so I wanted to make sure I didn't lose you.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, and you said for the reference, reference number it's gonna be your name, [PII], and today's date.
[AGENT][NEUTRAL] Number.
[AGENT][POSITIVE] And, yes, ma'am, that is correct.
[CUSTOMER][POSITIVE] OK, got it, thank you so much, Ms. [PII].
[AGENT][POSITIVE] Alright, well, you are certainly welcome. Is there anything else, [PII], that I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am, that will be all.
[AGENT][POSITIVE] All right. Well, thank you then for calling APL and I hope you have a very nice evening.
[CUSTOMER][NEUTRAL] You too as well. Bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.