AccountId: 011433970860
ContactId: 8750858a-c0ea-48da-bea6-84f793459675
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256070 ms
Total Talk Time (AGENT): 131952 ms
Total Talk Time (CUSTOMER): 59036 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/8750858a-c0ea-48da-bea6-84f793459675_20250430T20:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling for eligibility and benefits on the, on the patient, please.
[AGENT][NEUTRAL] Yeah, I can take eligibility and benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] My first name is [PII], it's [PII]
[AGENT][NEUTRAL] OK, and then [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's the direct line is area code [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] I believe I do. I have Z as in Zebra, Z as in Zebra 4831198.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so that is not one of our policy numbers. Um, ours don't begin with letters it's typically going to be a 01 or a 2 that it would start with. Um, do you maybe have their social? I could search for them that way.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I don't have your social, uh, with a name and date of birth help, or do I need to contact them for the social?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] No, we could try with their name if you wouldn't mind spelling out the first and last name for me.
[CUSTOMER][NEUTRAL] Of course, it's uh [PII], it's [PII]
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what state does this member live in?
[CUSTOMER][NEUTRAL] In [PII].
[AGENT][NEUTRAL] OK, and then uh what was the date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect. OK, so I was able to find her policy. Um, let me know when you're ready and I'll give you that correct policy number.
[CUSTOMER][POSITIVE] I am ready.
[AGENT][NEUTRAL] That is 02538157.
[CUSTOMER][POSITIVE] 57. Thank you.
[AGENT][NEUTRAL] Of course, and so this is currently active, uh, effective date was [PII].
[AGENT][NEUTRAL] And this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays. And we really need to check uh inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] Outpatient, please.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. The outpatient benefit, uh, per pays on a per calendar day basis, so it pays up to $250 max per calendar day.
[CUSTOMER][NEUTRAL] Got it. 250 pounds a day. And as far as the claims address, where can we submit those to?
[AGENT][NEUTRAL] Sure, it's I've got a mailing address, a fax number, and a payer ID I can give you. Um, our mailing address is [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] Sure, did you need that fax number or payer ID?
[CUSTOMER][NEUTRAL] I just do the pay ID?
[AGENT][NEUTRAL] OK, that's 60801.
[CUSTOMER][NEUTRAL] Thank you and by chance do you offer a call reference number?
[AGENT][NEUTRAL] Yes, it would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] And was there anything else I could help you with?
[CUSTOMER][POSITIVE] That would be it for now. Thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. Likewise.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][POSITIVE] Thank you.