AccountId: 011433970860
ContactId: 70a0e07b-b463-45ae-ac63-0336ce060d01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305760 ms
Total Talk Time (AGENT): 92018 ms
Total Talk Time (CUSTOMER): 102113 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/70a0e07b-b463-45ae-ac63-0336ce060d01_20250505T19:32_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, ma'am. My name is [PII].
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Hi, I'm calling from the provider office and looking for member eligibility and benefit verification. Can you please help me out?
[AGENT][NEUTRAL] Oh, I can help you. And is this for benefits in a doctor's office or outpatient facility?
[CUSTOMER][NEUTRAL] Uh doctor office?
[AGENT][NEUTRAL] OK. And do you have your policy number? And what's your first name?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] name [PII] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the number is 01419774. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] And [PII], what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] with the extension [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. Give me one moment to pull up the file, OK?
[CUSTOMER][NEUTRAL] Yeah, sure, ma'am.
[AGENT][NEUTRAL] Still pulling up the information.
[AGENT][NEUTRAL] Verify the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] Uh yes, ma'am. Patient uh first name, I have, uh,
[CUSTOMER][NEUTRAL] [PII], last name is [PII], and the date of birth I have [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sorry, you said [PII] for the birth, the date of birth?
[CUSTOMER][NEUTRAL] You said [PII].
[CUSTOMER][NEUTRAL] Um, date of birth, ma'am, I have [PII].
[AGENT][POSITIVE] Great, thank you. So I do have the information for you. I'm showing the policy effective date.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I show this policy is no longer active, so that means it's, it's termed effective [PII]. Uh there is no active coverage for this patient.
[CUSTOMER][NEUTRAL] Uh, so, ma'am, uh, the last termination date, what is the last termination date when the policy is then?
[AGENT][NEUTRAL] The last, did you say the last date the policy was effective?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] [PII] is the date that the policy turned.
[CUSTOMER][NEUTRAL] OK, ma'am. After the [PII], that policy is no longer active, I'm I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And, and can you find that uh this patient have any other active policy or not on file?
[AGENT][NEUTRAL] There is no other active policy for the patient, love. And did you have any other questions?
[CUSTOMER][NEUTRAL] OK, ma'am.
[CUSTOMER][NEUTRAL] No, ma'am. Thank you. May I know your name, please?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII], first initial last name is [PII].
[CUSTOMER][NEUTRAL] That we might be
[CUSTOMER][POSITIVE] Uh, OK. Thank you. Have a nice day. Bye-bye. Take care.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] And, ma'am, yeah, so sorry. Actually, can you please, yeah, uh, provide us any portal where we can see the benefits or not?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] They're not available. The eligibility and benefit, the eligibility and benefits are not available on the online service center or the portal.
[CUSTOMER][NEUTRAL] OK, so we need to call the insurance, am I right?
[AGENT][NEUTRAL] For eligibility and benefits, yes, you can check claim status online but not verify eligibility and benefits.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] OK. Thank you. Thank you, ma'am, for the information. Have a nice day. Bye-bye. Take care.
[AGENT][POSITIVE] Uh, you're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye.