AccountId: 011433970860
ContactId: 610f963b-f744-4a48-9947-c9d04b106a84
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283459 ms
Total Talk Time (AGENT): 134098 ms
Total Talk Time (CUSTOMER): 92751 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/610f963b-f744-4a48-9947-c9d04b106a84_20250411T12:05_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII] and I'm calling from Medical University of South Carolina. How are you?
[AGENT][POSITIVE] I'm good, [PII]. How are you today?
[CUSTOMER][NEUTRAL] I'm doing all right um I am calling because.
[AGENT][POSITIVE] Oh good. How can I help you this morning?
[CUSTOMER][NEUTRAL] I'm trying to verify eligibility on a policy please.
[AGENT][NEUTRAL] OK, [PII], you're only needing eligibility. You do not need benefits, is that correct?
[CUSTOMER][NEUTRAL] Uh, no, I just need the eligibility and I'll ask you, um, go ahead, yeah, sorry.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, well, I can help you with the eligibility. So [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and what is the member's policy number, please?
[CUSTOMER][NEUTRAL] It's 02592448.
[AGENT][NEUTRAL] OK thank you one moment, [PII] while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and any information, [PII], that I do provide would be a verification of benefits and not a guarantee of payment. What is the patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I do show that she is uh dependent on the supplemental policy, [PII], and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] And this is a supplement plan, is that right?
[AGENT][NEUTRAL] That is correct. This is a supplement to their primary insurance. So if a claim is going to be filed with APL, we will also have to have a copy of her primary insurance explanation of benefits as well along with the claim for review.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL [PII], we have a portal in which you should be able to check claim status and our website for that is located at [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, um, I just wanna make sure your mailing address is [PII] for claims.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, yeah, I don't have a primary insurance on her. I show her insurance actually terms, so would you consider that this is just a sub plan, a limited plan, or?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] No, it is a supplemental plan that helps with co-pays, deductibles, and co-insurance amounts of covered services. If you'll give me just a moment, I can see who we show as the primary insurance for her, but I wouldn't have detailed information. We show it to the Blue Cross and Blue Shield of South [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I have a Blue Cross that just firmed on [PII].
[AGENT][NEUTRAL] Oh, OK, we just.
[CUSTOMER][NEUTRAL] You don't have the policy.
[AGENT][NEUTRAL] For, I don't have any of the information for her primary. No, ma'am. You would have to reach out to them for that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right. OK, and [PII], your last name begins with what letter?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and network on this there's no network with us correct?
[AGENT][NEUTRAL] That is correct. It would follow their primary insurance.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Got it and uh call reference number or none?
[AGENT][NEUTRAL] Uh, you would use my name along with today's date.
[CUSTOMER][POSITIVE] OK, got it. All right, thank you so much. I appreciate your time.
[AGENT][NEUTRAL] OK, all right.
[AGENT][POSITIVE] Well, you're very welcome. So is there anything else I can help you with this morning?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] No, you've been great. I appreciate your time.
[AGENT][POSITIVE] OK. Well, you're certainly very welcome. It's my pleasure. Yes, ma'am. Thank you for calling APL [PII]. I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.