AccountId: 011433970860
ContactId: 8663b24c-e44d-47cd-a24f-c4c0a2a36cfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258160 ms
Total Talk Time (AGENT): 126343 ms
Total Talk Time (CUSTOMER): 132865 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/8663b24c-e44d-47cd-a24f-c4c0a2a36cfd_20250310T19:26_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, my name is [PII], and I'm calling from provider office to check on patient medical eligibility.
[AGENT][NEUTRAL] OK, [PII], you're only needing eligibility. You do not need benefit information, is that correct?
[CUSTOMER][POSITIVE] Yes. Yes, right.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you and the member's policy number please?
[CUSTOMER][NEUTRAL] 02140683
[AGENT][POSITIVE] Thank you, one moment, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And your patient, any information rather [PII] that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my first name, it's like [PII] and the last name it's [PII].
[AGENT][NEUTRAL] OK, now this member's name is
[CUSTOMER][NEUTRAL] On the date of birth?
[AGENT][NEUTRAL] Uh-huh, go ahead.
[CUSTOMER][NEUTRAL] Sorry, sorry.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now we have this number listed as just with the last name [PII]. It does not have [PII] on.
[AGENT][NEUTRAL] Our information.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, there, there is no Rod burgers, right?
[AGENT][NEUTRAL] Not on our information for her, that is correct.
[CUSTOMER][NEUTRAL] Yeah, OK. The first name it's [PII] and the last time you said [PII] That's all.
[AGENT][POSITIVE] That is correct. That is correct.
[CUSTOMER][POSITIVE] Thank you. Thank you.
[AGENT][NEUTRAL] And I do show that she is covered and the supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And [PII], if a claim is filed with APL on this policy, we must also receive a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal that you can check claim status in by going to secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So there is a supplement plan and the effective date it's [PII]. And is there any group number for the supplement plan?
[AGENT][NEUTRAL] Yes, there is, one moment.
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the records office to check the patient has been decided.
[AGENT][NEUTRAL] The group number is 17111.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] 17111. And may I know the payer ID and the claim's mailing address?
[AGENT][POSITIVE] That is good.
[AGENT][NEUTRAL] Payer ID 60801. Claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Yeah, so we don't
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry for that. Can you repeat the ZIP code?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And um can you spell your name?
[AGENT][NEUTRAL] [PII] and my name and today's date would be your call reference number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][POSITIVE] [PII] and thank you so much for your help and have a great day. Bye-bye.
[AGENT][POSITIVE] Yes, well, that is all I can help you with, and thank you again for calling APL and I hope you have a nice day as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm Bye-bye.
[AGENT][NEUTRAL] Bye-bye.