AccountId: 011433970860
ContactId: 7170e6a7-1fb1-445c-9da9-3e9daf89017b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309869 ms
Total Talk Time (AGENT): 84976 ms
Total Talk Time (CUSTOMER): 139239 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/7170e6a7-1fb1-445c-9da9-3e9daf89017b_20250212T16:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII] calling from the provider office to have specific question about the claim and this call is being recorded for quality and training purposes. Are you OK with that?
[AGENT][NEUTRAL] OK, that's fine. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Definitely. So the callback number we have is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Definitely. So the policy number we have here is
[CUSTOMER][NEUTRAL] 02000268.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][POSITIVE] Take your time, [PII].
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Definitely. So the member's uh name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Uh, so the claim was never billed. I just want to know if the member is active for the date of, uh, date of service, which is [PII].
[AGENT][NEUTRAL] Yes, this policy has been active since [PII].
[CUSTOMER][NEUTRAL] From [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, [PII] and it's still active.
[CUSTOMER][NEUTRAL] OK. And uh yeah, I have one more patient to check the same detail, just uh the eligibility.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] If the member is, uh, go ahead, take your time.
[AGENT][NEUTRAL] Let me note this policy.
[AGENT][NEUTRAL] OK, and the next member's policy number?
[CUSTOMER][NEUTRAL] Yes, so the next member ID is 01774117 ML.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Take your time, dear.
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Definitely. So my name is [PII] and uh then first name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. Again, all the information provided is a verification of benefits, not a guarantee of payment. And what is the data service you'd like to check?
[CUSTOMER][NEUTRAL] Uh, so the date of service I have is [PII].
[AGENT][NEUTRAL] OK, so this policy is no longer active.
[AGENT][NEUTRAL] It was effective from [PII], and there were no active policies after [PII].
[CUSTOMER][NEUTRAL] Me
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so right now the uh at the date of service member was inactive.
[AGENT][NEUTRAL] Right, there are no active policies since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No issues. And if the member has any surgery plan?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Can you check if member has any different um insurance active because I think uh USC is active for the member for the rate of service.
[AGENT][NEUTRAL] Right, but their policies, any policy that they have with us would have populated. They only have this one and it turned in [PII].
[CUSTOMER][NEUTRAL] OK, so the member does not have any other active policy, right?
[AGENT][NEUTRAL] With APL, correct.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] No issue. And um that's all I needed. Um the call reference number will be your name and today's date, right?
[AGENT][NEUTRAL] Yes, that's correct. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] And [PII] and the date of [PII]. OK. So [PII], thank you for helping me with this claim. That means a lot for me. Thank you. Have a great day. Bye-bye. Take care.
[AGENT][POSITIVE] You're very welcome, [PII]. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.