AccountId: 011433970860
ContactId: 7ffc30fb-aaf6-4210-94c7-cffc4b31aa56
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382399 ms
Total Talk Time (AGENT): 160656 ms
Total Talk Time (CUSTOMER): 121162 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/7ffc30fb-aaf6-4210-94c7-cffc4b31aa56_20250110T19:54_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling the provider office regarding the eligibility and benefits of the member.
[AGENT][NEUTRAL] OK, I'm so sorry. What was your name? I didn't understand it.
[CUSTOMER][NEUTRAL] It's the [PII]
[AGENT][NEUTRAL] [PII], OK. And [PII], you're needing eligibility and benefit information for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] It's A as in Alpha 6,014,516,200.
[AGENT][NEUTRAL] OK, OK, thank you, but that, that is not a policy number for our company. What company are you trying to reach?
[CUSTOMER][NEUTRAL] Uh, as I see the member, the claim has been billed to the American public.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] I'm sorry, to what company?
[CUSTOMER][NEUTRAL] Uh uh
[CUSTOMER][NEUTRAL] Is that Med clinic?
[AGENT][NEUTRAL] Now so what company are you trying to reach? That is not a the numbers.
[CUSTOMER][NEUTRAL] Uh, it's American Public Life.
[AGENT][NEUTRAL] OK, and what is the policy number for our company because that is not a policy number for American Public Life.
[CUSTOMER][NEUTRAL] OK, just let me check on the card was attached here. Just give me a second.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh. Sure.
[CUSTOMER][NEUTRAL] Um, card number was not given on the attached card.
[AGENT][NEUTRAL] OK. What other information do you have the full social security number?
[CUSTOMER][NEUTRAL] My number.
[CUSTOMER][NEUTRAL] No, we don't have the information for the social security number.
[AGENT][NEUTRAL] I can try to search by the name. I cannot search by date of birth. What is the last name of your patient?
[CUSTOMER][NEUTRAL] The last name is [PII]
[AGENT][NEUTRAL] OK, I'm sorry. You're gonna have to, yes, you're gonna have to start over.
[CUSTOMER][NEGATIVE] Sorry, what? I can't get you.
[AGENT][NEUTRAL] I need for you to spell the patient's last name.
[CUSTOMER][NEUTRAL] OK, the patient's last name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Are you saying [PII]?
[CUSTOMER][NEUTRAL] Uh, no, it's [PII].
[AGENT][NEUTRAL] [PII] Is that correct?
[CUSTOMER][POSITIVE] Yeah, correct.
[AGENT][NEUTRAL] OK, let me see if I can locate a member in our system.
[AGENT][NEUTRAL] And what claims mailing address was the claim mailed to?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK, that is not our claims mailing address, Deb.
[CUSTOMER][NEUTRAL] Uh, you can try with this another address like [PII].
[AGENT][NEUTRAL] No, sir. That's not our address either.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So is there another way like uh we can find out this patient to date of birth?
[AGENT][NEUTRAL] You would have to contact, uh, what state did they live in?
[CUSTOMER][NEUTRAL] Uh, yeah, uh, taxes.
[AGENT][NEUTRAL] OK. No, sir. I don't have anyone by that name who lives in the state of [PII].
[AGENT][NEUTRAL] With a policy
[CUSTOMER][NEUTRAL] No, the state reservation leave is [PII], sorry.
[AGENT][NEUTRAL] OK. So what is, first off, any, OK, any information provided would be a verification of benefits and not a guarantee of payment. What is this patient's date of birth?
[CUSTOMER][NEUTRAL] Uh, his date of birth is [PII].
[AGENT][NEUTRAL] I
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Is the patient found?
[AGENT][NEUTRAL] Uh, this patient's policy was never active with our company. It was
[AGENT][NEUTRAL] The effective date and the term date of are the same, which was [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] This, this means she does not have an active policy. She's never had an active policy with APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, can we get the benefit details for that?
[CUSTOMER][NEUTRAL] Is it possible or not?
[AGENT][NEUTRAL] There was no policy active with our company. The effective date and term date are the same date.
[AGENT][NEGATIVE] She never had active coverage with us.
[CUSTOMER][NEUTRAL] OK. Did the patient have any other, uh, any, did the patient have any other policy? No?
[AGENT][NEUTRAL] No, there is.
[AGENT][NEUTRAL] There is no other policy with our company and in order to find out if the insured did have any other, what other coverage rather she did have, you would have to contact her.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK then, thank you so much for providing with this information. I appreciate your efforts there.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Absolutely. You're very welcome, [PII]. So that's all then that I can help you with. Thank you again for calling APL and I hope that you have a nice weekend.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Yeah. Thank you. Bye-bye.
[AGENT][POSITIVE] Mm thank you. Bye-bye.