AccountId: 011433970860
ContactId: 79e5c5db-6f6d-451a-946b-3c142ec216fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226270 ms
Total Talk Time (AGENT): 88624 ms
Total Talk Time (CUSTOMER): 74497 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/79e5c5db-6f6d-451a-946b-3c142ec216fd_20250106T15:04_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, I'm, my name is [PII]. I'm calling from Sunco Surgical Associates.
[CUSTOMER][NEUTRAL] And we, we had a patient that saw one of our doctors in the emergency room and they had, um, APL insurance. I'd just like to check it for benefits and eligibility.
[AGENT][POSITIVE] Sure, [PII], I can assist you with that. I have a callback number for you and that policy number.
[CUSTOMER][NEUTRAL] Yeah, the best number to call me back on is [PII].
[AGENT][NEUTRAL] Thank you and what's the policy number of the member?
[CUSTOMER][NEUTRAL] The policy number is 025.
[CUSTOMER][NEUTRAL] 382.
[CUSTOMER][NEUTRAL] 71.
[AGENT][NEUTRAL] And could you verify that patient's name and date of birth that you're inquiring eligibility for?
[CUSTOMER][NEUTRAL] OK, it's
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And what what else do you need to know sorry?
[AGENT][NEUTRAL] The date of birth?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're calling to verify outpatient benefits?
[CUSTOMER][NEUTRAL] Yeah, they, they have the
[CUSTOMER][NEUTRAL] Gallbladder removed on the [PII], uh no, no appendix sorry.
[AGENT][NEUTRAL] So this surgical
[AGENT][NEUTRAL] Is that for surgical benefits?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, thank you. So I'm gonna transfer you, go ahead.
[CUSTOMER][NEUTRAL] For a specialist.
[AGENT][NEUTRAL] What were you about to say, [PII]?
[CUSTOMER][NEUTRAL] I was just gonna say how you could um it may be on the specialist.
[AGENT][NEUTRAL] Got you. So you wanna verify outpatient services for uh surgery, correct?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Surgery benefits, is that what you're calling about? The, the patient had surgery done?
[CUSTOMER][POSITIVE] Well, I'm making sure they really got an active plan.
[CUSTOMER][NEUTRAL] And I was going to ask you for the address we would send claims to.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Got you. So let me transfer you to the correct queue so I can better assist you. Hold one moment.
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Sing.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Good morning. Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hi [PII], how are you doing?
[CUSTOMER][POSITIVE] I'm doing well thank you how are you?
[AGENT][NEUTRAL] I'm great, thanks for asking. This is [PII] in the [PII]. I have a provider on the on the phone by the name of [PII]. He's calling to verify HI benefits for a member. He said that the member came in for an ER visit, however, ended up getting a surgery to remove a corrupt appendix.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me give you the policy number. Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] It is 253-827-1. That's 253-827-1.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] And his his name is [PII].
[AGENT][NEUTRAL] Yes. And callback number? Go ahead.
[CUSTOMER][NEUTRAL] And he's wanting eligibility?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And call back number is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 01 moment.
[CUSTOMER][POSITIVE] Thank you [PII].
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Hello [PII], I'm gonna transfer you over to someone that can better assist you. Thanks for calling APL and have a great day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] That's perfect.