AccountId: 011433970860
ContactId: 6de16329-830c-4bab-8c64-262513b6b532
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249070 ms
Total Talk Time (AGENT): 79589 ms
Total Talk Time (CUSTOMER): 144569 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/6de16329-830c-4bab-8c64-262513b6b532_20250401T18:59_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon [PII]. My name is [PII]. I'm calling from a provider's office, um, to get to obtain benefits, um.
[CUSTOMER][NEUTRAL] Eligibility and exactly.
[CUSTOMER][NEGATIVE] I need your help because I don't know.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If I, um, there's an ID number here or not, so I need you please.
[AGENT][POSITIVE] OK. Well, I'll be more than happy to help you with the eligibility and the benefits. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Absolutely [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] That's the thing, um.
[CUSTOMER][NEUTRAL] I don't know it doesn't have one it just has a payer ID um.
[AGENT][NEUTRAL] do you see anywhere that says
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Uh, it, it says the lady's name it says coverage individual group number.
[CUSTOMER][NEUTRAL] Um, 23,820 effective date and then it says plan med link select group medup.
[CUSTOMER][NEUTRAL] And then it says in hospital benefits cert number and then outpatient benefits cert number.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, the numbers are the same, the ML.
[CUSTOMER][NEUTRAL] And then payer ID on the upper right hand corner, uh huh.
[AGENT][NEUTRAL] The numbers are the same in the policy certification number, the ML 7 or 8 at the end is different. I just need the numbers. That's the policy number.
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][NEUTRAL] That's what it is, OK, um, OK, well, it's not for inpatient, it would be outpatient because it's for, uh, specialist office visit, um, so 025.
[AGENT][NEUTRAL] The numbers are the same.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, 02571901.
[CUSTOMER][NEUTRAL] And then M like Mary, L like Larry, and then number 8 at the end.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] I most certainly can her name is?
[CUSTOMER][NEUTRAL] Bear with me please. [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So the policy is active, it's been effective since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And um you said that it was outpatient, what type of uh benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, specialist office visit.
[AGENT][NEUTRAL] OK. So for this policy, there is no coverage for the office setting. Um, it will only be inpatient and outpatient facilities.
[CUSTOMER][NEGATIVE] So like imaging facilities, ERs, um, urgent care places and things of that nature? OK, so it wouldn't even bother, I would, I shouldn't even bother on.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Well, I'm gonna enter it, but the sec and I'll put a note that the secondary is only for hospitals and urgent cares and and stuff like that. OK, um, can I please get a, can I please get a reference um number for our call today and I wanna thank you so much for your help.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] You're welcome, [PII]. So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] And what was your name again, sweetheart?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII], that's right, [PII], and you said the last initial is.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Oh, OK, and today's date. Thank you so much, Ms. [PII]. You have a great rest of your day.
[AGENT][NEUTRAL] You also [PII], was there anything else I can help with?
[CUSTOMER][POSITIVE] No ma'am, that's about it thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Yep bye bye.