AccountId: 011433970860
ContactId: 8019d3b7-e409-40a6-9ea1-d52dc37f0184
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288459 ms
Total Talk Time (AGENT): 81168 ms
Total Talk Time (CUSTOMER): 134161 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/8019d3b7-e409-40a6-9ea1-d52dc37f0184_20250620T19:29_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] And uh, my name is [PII] and I'm calling from a provider's office to verify benefits. We have a patient here that has presented this insurance card, and we just need to verify that he has coverage.
[AGENT][POSITIVE] OK, well I can definitely help you with the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. May I have the member's policy number?
[CUSTOMER][NEUTRAL] OK, would that be the employee ID?
[CUSTOMER][NEUTRAL] This card, it doesn't, it says employee ID on it. There's a group number employee name and and the.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] Does the card on at the top left corner say APL?
[CUSTOMER][NEGATIVE] Uh, no, it does not.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Based on what he had scanned, hold up, the patients, he didn't bring a card. All I have is what's scanning the computer. This patients showed up not really.
[AGENT][NEUTRAL] Do you have a
[CUSTOMER][NEUTRAL] Let me ask the person, he's standing at um the check-in desk. Maybe the card he has scanned on his phone, his phone has something different. You said that in the top left hand corner.
[AGENT][NEUTRAL] Do you have his social on file?
[CUSTOMER][NEUTRAL] I do have a social, um.
[AGENT][NEUTRAL] OK, we can search it with that.
[CUSTOMER][NEUTRAL] OK, great. OK, hold on just a second, let me get back. His social security number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm just waiting for the policies to come up here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the member's first and last name?
[CUSTOMER][NEUTRAL] Uh, I don't know how to say his name. It's um it's the first name is spelled [PII]
[CUSTOMER][NEUTRAL] And the last name [PII]
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And did you need to go over any benefits today?
[CUSTOMER][NEUTRAL] Um, yes, it does he, we just need to make sure he's in network here, um, if, if it, and also does he have medical benefits?
[AGENT][NEUTRAL] Um, so this is a dental policy. Um, hold on one second, let me see if he has any.
[CUSTOMER][NEUTRAL] Oh, so this.
[AGENT][NEUTRAL] Yes, this is a dental-only policy. This, this isn't a medical policy.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, so he's presenting his card as if it's a medical.
[AGENT][NEUTRAL] And it dental, mhm.
[CUSTOMER][NEUTRAL] So he didn't have medical coverage then?
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Not just, if he does, it's just not with APL.
[CUSTOMER][NEUTRAL] Because that
[AGENT][NEUTRAL] So I like I wouldn't be able to confirm.
[CUSTOMER][NEUTRAL] OK, so, um, what I did, I.
[CUSTOMER][NEUTRAL] Yeah, and I talked to someone with 90 degree benefits and they told me I need to call back and um and press the options for hospital indemnity.
[CUSTOMER][POSITIVE] And that's how I got you.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So then that would be correct.
[CUSTOMER][NEUTRAL] Because they, they said I need to press the option for hospital and and indemnity to get the correct for medical.
[AGENT][NEUTRAL] OK, so if that's the case, then I'm, yeah, I'm just gonna go with that. So then yes, uh, because all he has here is dental.
[CUSTOMER][POSITIVE] OK, alright then that that's correct.
[CUSTOMER][POSITIVE] I appreciate your help.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am, not at this time.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. I hope you have a great weekend. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.