AccountId: 011433970860
ContactId: 76376961-a3a4-4613-9435-250cb8f665ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 337839 ms
Total Talk Time (AGENT): 152927 ms
Total Talk Time (CUSTOMER): 186912 ms
Interruptions: 20
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/76376961-a3a4-4613-9435-250cb8f665ea_20250514T14:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you for calling APL, this is.
[CUSTOMER][NEUTRAL] Good morning. This is [PII] from Mount Sinai Center for check eligibility.
[AGENT][NEUTRAL] OK, did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] OK, did you think that your name is [PII].
[AGENT][NEUTRAL] OK, [PII], and you're needing only eligibility for a member, is that correct?
[CUSTOMER][NEUTRAL] Hey [PII]
[CUSTOMER][NEUTRAL] phone number, is that correct? Yes.
[AGENT][POSITIVE] Yes, I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][POSITIVE] Yes, I can help you with that, [PII]. What is your call back?
[CUSTOMER][NEUTRAL] OK. My callback number is [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][POSITIVE] Thank you and the policy number.
[CUSTOMER][NEUTRAL] The member's policy is 01659284.
[AGENT][NEUTRAL] 01659284. Is that correct?
[CUSTOMER][NEUTRAL] 01659284, is that correct? Yes.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], any information provided will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] have any information.
[CUSTOMER][NEUTRAL] not a guarantee payment.
[CUSTOMER][NEUTRAL] The patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII].
[CUSTOMER][NEUTRAL] And date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I need to give you a different policy number, [PII], for this member.
[CUSTOMER][NEUTRAL] OK, I need to give you a different policy number, [PII], for this number.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] The policy number you gave me is not active. I need to give you the policy number that is active.
[CUSTOMER][NEUTRAL] The policy number you gave me is not active. I need to give you the policy number that is that.
[CUSTOMER][NEUTRAL] OK, I want to know if that member was active, but um.
[CUSTOMER][NEUTRAL] On with you on [PII].
[AGENT][NEUTRAL] OK, under a different policy number. Yes, not under this policy number.
[CUSTOMER][NEUTRAL] under a different policy number.
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] This policy term, the policy number you gave me termed 112024.
[CUSTOMER][NEUTRAL] This policy, the policy number you gave me 112024.
[AGENT][NEUTRAL] And there is another policy that went into effect, [PII] and is still currently active.
[CUSTOMER][NEUTRAL] And there is another policy that went into effect. [PII] and it still currently active.
[CUSTOMER][NEUTRAL] OK, just to make sure, you said the member was not active with you on [PII], right?
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] No, ma'am, that's not what I said.
[CUSTOMER][NEUTRAL] No ma'am, that's not what I do.
[AGENT][NEUTRAL] I said that the policy number that you gave me.
[CUSTOMER][NEUTRAL] I said that the policy number that you gave me.
[AGENT][NEUTRAL] Termed 11 2024.
[CUSTOMER][NEUTRAL] Um 11 2024.
[AGENT][NEUTRAL] There is another policy number that went into effect on [PII] and is still active.
[CUSTOMER][NEUTRAL] There is another policy number that went into.
[CUSTOMER][NEUTRAL] 11
[CUSTOMER][NEUTRAL] For and it's still out.
[CUSTOMER][POSITIVE] OK, that's perfect thank you so much.
[AGENT][NEUTRAL] So the policy number?
[AGENT][NEUTRAL] Yes, the policy number that you need is 02505720.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's 02
[CUSTOMER][NEUTRAL] 50.
[CUSTOMER][NEUTRAL] 5720.
[AGENT][POSITIVE] Effective [PII] and it is active.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Now, [PII], if you all will be filing a claim for this member on this policy, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] And [PII], if you all will be filing a claim with you.
[CUSTOMER][NEUTRAL] this
[CUSTOMER][NEUTRAL] We also have to have a top of the primary.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] with the
[AGENT][NEUTRAL] And then once we have processed a claim, we do have a portal in which you should be able to check claim status, and that portal website is located at secured.
[CUSTOMER][NEUTRAL] On a
[CUSTOMER][NEUTRAL] You should be able to check on status.
[CUSTOMER][NEUTRAL] And that's one website is located.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] OK, that's perfect. um just to make sure, can you repeat um the policy number please, the new policy number.
[AGENT][NEUTRAL] 02505720
[CUSTOMER][NEUTRAL] 572.
[CUSTOMER][NEUTRAL] 0250.
[AGENT][NEUTRAL] 57.
[CUSTOMER][NEUTRAL] 57.
[AGENT][NEUTRAL] 20.
[CUSTOMER][POSITIVE] OK, thank you so much and do you have a reference number for this call?
[AGENT][POSITIVE] You are very welcome.
[AGENT][NEUTRAL] Yes, ma'am. You would use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] Use my name that I gave.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for confirming the information.
[AGENT][POSITIVE] Yes, ma'am, you're very welcome. And so again, is there anything else that I could help you with today?
[CUSTOMER][NEUTRAL] You're very welcome. And again, is there anything.
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] OK, [PII]. Well, you're very welcome and thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] [PII], well you're very welcome and thank you for calling ATS. I hope you have a wonderful day. Thank you.