AccountId: 011433970860
ContactId: 7b5a8498-c358-4c9f-b6c1-7c7582b61c2d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 332140 ms
Total Talk Time (AGENT): 193600 ms
Total Talk Time (CUSTOMER): 132252 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/7b5a8498-c358-4c9f-b6c1-7c7582b61c2d_20250219T18:21_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm, uh, my name is [PII]. I'm trying to find out my plan ID number, uh, for myself personally. I'm trying to file something with, uh, a Bay Area hospitalist and, uh, it doesn't seem to be on the card.
[AGENT][NEUTRAL] OK, Mr. [PII]. So you have a policy with APL and you're needing to verify what your policy number is. Is that correct? Yes, sir, I can help you with that.
[CUSTOMER][NEUTRAL] Yes, mhm, plan, yeah, plan number ID number, whatever.
[AGENT][NEUTRAL] OK. Well, and what is, I can help you. What is your callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have, do you have your ID card there?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] OK, so depending on the type of coverage, Mr. [PII] that you have with APL as to how it would be worded, do you see a policy certificate, an in hospital or outpatient number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I see an in-hospital benefit certificate number 02088034ML7.
[AGENT][NEUTRAL] Anything like
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. So give me just a moment to get your information pulled up, then I will have to verify several things with you first, Mr. [PII] for security and any information that I do provide would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, now we have something else on file for you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. So is that address no longer valid for you?
[CUSTOMER][NEUTRAL] No, it's that's now a rental property. I own it, but I don't live there.
[AGENT][NEUTRAL] OK, so, OK, so what is the um updated address that we need to have on file for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and the phone number that you gave me, the [PII], that's your best contact number that we should have on file?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, yes it is.
[AGENT][NEUTRAL] OK, thank you. And lastly, I do need to add an email address for you, Mr. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, I'm gonna repeat the address back and also your email. So the street address is [PII] and your email address is [PII].
[CUSTOMER][NEUTRAL] Yes mhm.
[AGENT][NEUTRAL] OK, thank you. So the policy number, OK, if you'll notice on your ID cards, Mr. [PII], you're in hospital and the outpatient number.
[CUSTOMER][NEUTRAL] Yep, OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Are the exact same before the letters ML.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] The, so that's your actual policy number. The 02.
[CUSTOMER][NEUTRAL] The numbers minus the ML.
[AGENT][NEUTRAL] Yes, those just indicate with the provider if this is for an in-hospital admission or an outpatient service. So if it's for out
[CUSTOMER][NEUTRAL] OK, hang on, hang on, I'm sorry, hang on just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK, the policy number or uh for this is 020.
[CUSTOMER][NEUTRAL] 88034.
[CUSTOMER][NEUTRAL] OK, so you said 020.
[CUSTOMER][NEUTRAL] 88034.
[CUSTOMER][NEUTRAL] OK, OK, what are they to send the claims to?
[AGENT][NEUTRAL] The address that is on your ID card.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That is correct, yes sir.
[CUSTOMER][POSITIVE] All right perfect I will go ahead and get that taken care of.
[AGENT][NEUTRAL] And they will also need to include a copy of your primary if they're gonna be filing a claim, they will also need to send it.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you, have a good day, sir.
[CUSTOMER][NEUTRAL] I'm sorry, say that again.
[AGENT][NEUTRAL] When claims are submitted on this type of policy you need to make sure that if the providers filing the claim for you that they also include a copy of your primary insurance company's explanation of benefits as well because we do have to have that.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then Mr. [PII], I don't know if you're familiar with our portal, but we have a portal for our members called the online service center and I'm going to email you the user guide for how to set up your profile.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the email that you're gonna receive from me will come from care team [PII] [PII] and I have put APL online service center portal in your subject line for you.
[CUSTOMER][POSITIVE] OK, great.
[AGENT][NEUTRAL] OK. Well, is there anything else I can help you with at the moment?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] No, that's it thanks for your help.
[AGENT][POSITIVE] Absolutely. You're welcome and thank you again for calling APL. I hope you have a wonderful afternoon.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.