AccountId: 011433970860
ContactId: 79ece567-a7fc-4234-89f8-d2c83e76fa89
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251000 ms
Total Talk Time (AGENT): 120099 ms
Total Talk Time (CUSTOMER): 88806 ms
Interruptions: 5
Overall Sentiment: AGENT=1.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/79ece567-a7fc-4234-89f8-d2c83e76fa89_20250512T13:15_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. Last name initial is [PII], calling from provider office, and I want to check patient eligibility.
[AGENT][NEUTRAL] OK, [PII], you're needing eligibility for a member, is that correct?
[CUSTOMER][NEUTRAL] OK, [PII] you eligibility for a member, is that correct?
[AGENT][NEUTRAL] Yes, sir. I can help you with that. And what is your callback number please, [PII]?
[CUSTOMER][NEUTRAL] Yes, I can help you with that. And what is your callback number [PII] direct line.
[AGENT][NEUTRAL] Thank you. And what is the patient's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] Thank you. And what is the policy number, please? The member policy number is 02581461 M for Mary L for Lima 8.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK [PII], 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 please and their date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do show that he is the subscriber on the supplemental plan and this supplemental plan is active with an effective date of [PII].
[AGENT][NEUTRAL] And [PII], if you can make a note that when the claim is submitted to us for review, we will also have to have a copy of his primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] And then once we have processed.
[CUSTOMER][NEUTRAL] No, I just need the.
[AGENT][NEUTRAL] I'm sorry, I thought you needed the eligibility. Mhm.
[CUSTOMER][NEUTRAL] Yeah, please continue.
[AGENT][NEUTRAL] So yes, we must also receive a copy.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Go ahead, [PII].
[CUSTOMER][NEUTRAL] Go ahead
[CUSTOMER][NEUTRAL] I just need a patient eligibility. The effective date is [PII] and the patient is still like, am I right?
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] But I also need to give you this additional information since it is required when reviewing a claim.
[CUSTOMER][POSITIVE] OK, thank you. Uh please
[CUSTOMER][NEUTRAL] Yeah, please go ahead.
[AGENT][NEUTRAL] So again you all must submit the primary explanation of benefits to APL as well.
[AGENT][NEUTRAL] Along with the claim for review and then once the claim has been processed by APL we have a portal in which you should be able to check claim status and our portal website is located at [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. And is there anything else that I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Welcome.
[CUSTOMER][NEUTRAL] No, no, thank you. So the effective date is [PII] and the patient is still active. Uh, can I get a call or phone number for this number?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] My name that I gave you along with today's date and the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Can you please spell out your first name?
[AGENT][NEUTRAL] It is [PII], [PII]
[CUSTOMER][NEUTRAL] It is [PII]
[CUSTOMER][POSITIVE] OK, thank you for the information. Have a good day. Bye-bye.
[AGENT][POSITIVE] You too, [PII], and thank you for calling APL. I hope you have a nice day as well, and if that's all I can help you, thank you again for calling.
[CUSTOMER][POSITIVE] Hey [PII] and thank you for calling ATL. I hope you have a nice day as well, and if that's all I can help you, thank you again for calling. Bye bye.
[AGENT][NEUTRAL] Bye bye.