AccountId: 011433970860
ContactId: 7632c5a7-e8bf-4819-ac5d-02406a721b0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300709 ms
Total Talk Time (AGENT): 140556 ms
Total Talk Time (CUSTOMER): 166688 ms
Interruptions: 7
Overall Sentiment: AGENT=1.2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/7632c5a7-e8bf-4819-ac5d-02406a721b0c_20250529T18:26_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes. Hi. Good afternoon, [PII]. My name is [PII] and then M [PII]. Um, I have a member that's, um, in our hospital under observation. I was trying to um check eligibility, please.
[AGENT][NEUTRAL] OK, [PII], you're needing eligibility for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes, and also to check to see if an author is required, which I don't think it is, but.
[AGENT][POSITIVE] Yes, I can help you with both. And Dom, what is your callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] 02599267M.
[CUSTOMER][NEUTRAL] L and then 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And any information that I do provide today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on the supplemental policy, [PII].
[AGENT][NEUTRAL] And it is active, effective [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there is no prior authorization required on the supplemental coverage.
[CUSTOMER][NEUTRAL] Got you and um let's see oh do you have her name? oh go ahead.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Now when, uh-huh.
[AGENT][NEUTRAL] No, go ahead with your question.
[CUSTOMER][NEUTRAL] Oh, is, um, do you have her name as [PII] or just [PII] or do you have the middle initial?
[AGENT][NEUTRAL] [PII] middle initial, [PII] Mhm.
[CUSTOMER][NEUTRAL] OK, that's how you got you. Alright. And then is there a, go ahead.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] No, go ahead with your questions and then I'll give you.
[CUSTOMER][NEUTRAL] Uh, I, oh, I was, um, we have a couple of fields we have to fill out if it's applicable. Is there a group number?
[AGENT][NEUTRAL] Yes, ma'am, and that should also be on her ID card. It is 23143.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is there a group name?
[AGENT][NEUTRAL] Nova Southeastern University.
[CUSTOMER][NEUTRAL] 23143.
[CUSTOMER][NEUTRAL] Oh, got you. Hold on. Oh yeah, I know what that is. OK, so Eastern University, oops, uh, I have to get out of this, um, I am thing. So how do I bear with me. Let me leave this, uh, meeting that I'm in over south here so I don't keep getting I am.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure, go ahead.
[AGENT][POSITIVE] Yes ma'am, yes fine.
[AGENT][POSITIVE] Yeah, I know the system's right.
[CUSTOMER][NEUTRAL] Oh, OK, cancel.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, OK, sorry about that. OK, so we got uh that effective. She's still active and office is not required. That's actually all I needed. I'm still in the group.
[AGENT][NEUTRAL] No, that's OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK. Oh goodness.
[CUSTOMER][NEUTRAL] 00, and for documentation.
[AGENT][NEUTRAL] I understand how that is, though.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I have the um uh the first initial of your last name please?
[AGENT][NEUTRAL] You may. It's [PII], and my name in today's date um will be your call reference number. Um, and the
[CUSTOMER][POSITIVE] Got you. Awesome.
[AGENT][NEUTRAL] Just wanted to give you a couple additional pieces of information because it is a supplemental policy when the claim is submitted to us for review, we will have to have a copy of her primary insurance company's explanation of benefits as well. And then once we have processed the claim here at APL, we do have a portal that you all should be able to check claim status in.
[CUSTOMER][NEUTRAL] Uh-huh, sure.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And our website for the portal is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh wait [PII] right, hold on, hold on, wait.
[AGENT][NEUTRAL] [PII]. [PII].
[CUSTOMER][NEUTRAL] Oh, and it's OK, that's OK, [PII]. OK, I put it on there but I don't, yeah, I don't do that that part that's another people that another group, but I did put it in there.
[AGENT][NEUTRAL] Yes, ma'am. OK. Right, yeah.
[AGENT][POSITIVE] Sure, sure. As long as that's perfect. OK, then. OK, is there anything else I can help you with?
[CUSTOMER][POSITIVE] OK. All right. Thank you so much.
[CUSTOMER][POSITIVE] Oh no that's it have a great day I appreciate your help.
[AGENT][POSITIVE] Well, you're welcome, [PII], and thank you again for calling APL. I hope you have a great afternoon as well.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Yes, ma'am. Bye-bye.