AccountId: 011433970860
ContactId: 64b039ae-ec2a-4921-8831-b137dd2ffdee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347260 ms
Total Talk Time (AGENT): 117663 ms
Total Talk Time (CUSTOMER): 119036 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/64b039ae-ec2a-4921-8831-b137dd2ffdee_20250624T14:51_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from a provider's office. I have a member ID. I want to obtain eligibility and would like to verify the billing address that I have and want to check if there is any deductible.
[AGENT][NEUTRAL] OK. All right, and may I have a callback number just in case we get disconnected, Mr. [PII].
[CUSTOMER][NEUTRAL] Yeah, it is [PII] direct line.
[AGENT][NEUTRAL] OK. What's the name of the facility you're calling from, Mr. [PII]?
[CUSTOMER][NEUTRAL] It's Sheridan health card.
[AGENT][NEUTRAL] Sheridan
[CUSTOMER][NEUTRAL] Yeah, Sheridan help for.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK. And may I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, it is 01885448 ML that is Mike Lima 8.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] [PII].
[AGENT][NEUTRAL] Do you have another last name for [PII]?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] Uh, no, actually not.
[CUSTOMER][NEUTRAL] Uh, let me check if there is any on the question.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, there is another last name [PII].
[AGENT][NEUTRAL] OK. And can you repeat that date of birth one more time?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, thank you. All right, let me see if I have a new policy. This one is terminated. Bear with me, Mr. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I didn't find a new policy. Let me know when you're ready for that new policy number.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, that new policy number is 02486618.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, so it's 02486618, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] And any effective date?
[AGENT][NEUTRAL] Uh, [PII], it is active at the moment.
[CUSTOMER][NEUTRAL] OK. And the billing address that I have for American Public Life is [PII], [PII], OK, [PII]. Is it correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Any electronic bill ID?
[AGENT][NEUTRAL] OK, this is a secondary supplemental plan, so we need the claim either to be faxed or mailed. I can give you the payer ID for your records, but the claim needs to be faxed or mail, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Right. Mhm.
[AGENT][NEUTRAL] OK, the payer ID is 60801.
[CUSTOMER][NEUTRAL] 60801. And is there any deductible for this policy?
[AGENT][NEUTRAL] Um, let me check, uh, and what type of service is being rendered?
[CUSTOMER][NEUTRAL] Uh, I have to check that one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Inpatient emergency.
[AGENT][NEUTRAL] Inpatient emergency?
[AGENT][NEUTRAL] All right, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So is it gonna be uh like hospitalization, 18 hours or more, or is it gonna be emergency outpatient?
[CUSTOMER][NEUTRAL] Yeah, yeah. Hospital.
[CUSTOMER][NEUTRAL] Uh, it's emergency inpatient in Memorial Regional Hospital and the, uh, at DX code is incidental pregnancy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, with us there's no deductible and this is not a guarantee of payment, just a verification of coverage. The inpatient maximum is 4000 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And um your name, please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] That will be all. Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling ATM. Have a good day.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][POSITIVE] Thank you. Mm.