AccountId: 011433970860
ContactId: 7f81751f-cf1c-4872-a95e-9197e5dc360c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263809 ms
Total Talk Time (AGENT): 156342 ms
Total Talk Time (CUSTOMER): 79720 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/7f81751f-cf1c-4872-a95e-9197e5dc360c_20250416T16:57_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] I'm sorry, you said your name is [PII]?
[AGENT][NEUTRAL] OK yes.
[CUSTOMER][NEUTRAL] I'm sorry, your, your phone is cutting out really badly, I'm gonna, I'm gonna do my best to hear you. Um, [PII], I'm calling from Orlando Health Medical Group. I need to verify patient eligibility and where I can submit claims. Would you be able to assist?
[AGENT][NEUTRAL] OK, so you're needing to verify eligibility only and get a claims mailing address, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is your name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] And [PII]?
[AGENT][NEUTRAL] And [PII]
[AGENT][NEUTRAL] OK, thank you, and then [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] 246-2340.
[AGENT][NEUTRAL] OK, thank you. Give me one moment please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Thank you. [PII], can I have the initials of your last name if possible?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][POSITIVE] Thank you. [PII]?
[AGENT][NEUTRAL] [PII] like, I'm sorry, did you say [PII]?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and any information that I do provide for you and [PII] would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, [PII] Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. So I see that she had been a dependent on this policy. Now this particular policy is no longer active. This policy was active from [PII].
[AGENT][NEUTRAL] To [PII].
[AGENT][NEUTRAL] Is your date of service within that range?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, it's not. It's after. OK, so that's good at least when she gets billed it's OK.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] OK, so there is another policy that is now active with a different policy number.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And that policy number is 259-7600.
[AGENT][NEUTRAL] It has an effective date of [PII].
[AGENT][NEUTRAL] And she is also covered on this policy.
[CUSTOMER][NEUTRAL] OK, so I just have an old number. It looks like the 2340 is an old number.
[AGENT][NEUTRAL] You have, you do.
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] Correct. So that you would use the new number if it's mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I just wanna go over it and make sure I got it right. It was 2597 600 and it's active as of [PII]. Perfect. OK. Um, and
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Um, and the claim's mailing address is going to be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is going to be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. OK. So then I just need a reference number for, I'm sorry, go ahead.
[AGENT][NEUTRAL] And internet
[AGENT][NEUTRAL] That's OK. So I just wanted to give you a couple of additional pieces of information because this is a supplemental policy to the primary health care insurance and the claim is submitted to us for review, we will have to also have a copy of the primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] As well, and then once we process our claim, we do have a portal that you should be able to check claim status in and that website for our portal is secured. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. All right, perfect. Um, so then I just need a reference number for our conversation. I'm gonna correct this ID number, get them submitted.
[AGENT][NEUTRAL] All right, and my, you would use my name along with today's date as the call reference number.
[CUSTOMER][POSITIVE] Perfect. All right. Thank you so very much, [PII]. You have a great rest of your day.
[AGENT][POSITIVE] Well, you're welcome. Yes, you too, and [PII] that's all I can help you with, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Um, bye bye.