AccountId: 011433970860
ContactId: 87cde1ab-c354-45d2-9e0a-0a0719f43233
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287040 ms
Total Talk Time (AGENT): 114913 ms
Total Talk Time (CUSTOMER): 132551 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/87cde1ab-c354-45d2-9e0a-0a0719f43233_20250414T16:56_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from CHI Saint Francis Medical Center. I'm calling to verify patient's eligibility.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yeah, the callback number is [PII].
[CUSTOMER][NEUTRAL] Um, the employee policy number is D as in dog 48800017.
[AGENT][NEUTRAL] I do apologize, but that's not a policy number here at American Public Life. Do you have that member's social?
[CUSTOMER][NEUTRAL] Do I have what?
[AGENT][NEGATIVE] The members social because that's not a policy number here at American Public Life, unfortunately.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, because I'm looking at their insurance card, um, I did find this number on it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is correct. However, this is a third party administrator and that policy number is not American Public's Life policy number for that member.
[CUSTOMER][NEUTRAL] So I don't know where I need to call.
[CUSTOMER][NEUTRAL] OK um.
[AGENT][NEUTRAL] So do you have their social?
[CUSTOMER][NEUTRAL] What do you mean function?
[AGENT][NEUTRAL] The social, their social security number?
[CUSTOMER][NEUTRAL] Oh, their social sorry sorry I could not hear you. um, yes, I do have their social. It is [PII] yep, so it's [PII].
[AGENT][NEUTRAL] And can I
[AGENT][NEUTRAL] What is this member's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] maybe [PII]. I don't know how to pronounce it, um, her date of birth is [PII].
[AGENT][NEUTRAL] This is for medical or dental.
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] So let me give you the policy number. Let me know when you're ready for it.
[CUSTOMER][POSITIVE] Oh, OK, so alright, I am ready.
[AGENT][NEUTRAL] So when you call American Public Life, this is the policy number that you will provide us. This is the policy number that you will use to submit a claim. It's 259-591-9. That's 2595919.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This policy has been active since.
[CUSTOMER][NEUTRAL] And it's American Public Life.
[AGENT][NEUTRAL] Yes, this policy has been active since [PII], I'm sorry, [PII] and it's currently active.
[AGENT][NEUTRAL] And what benefits are you inquiring about today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I think they were just here for a mammogram.
[AGENT][NEUTRAL] The member has a diagnostic testing benefit rider.
[AGENT][NEUTRAL] Of $125 per
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] year and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[AGENT][NEUTRAL] So would it be for wellness or just a screening for the mammogram?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, I'm not too.
[CUSTOMER][NEUTRAL] She had, I was just calling from the admissions department to verify eligibility so um it looks like she's employed through I guess SAI staffing so we don't go by the employee ID there then I guess for her insurance.
[AGENT][POSITIVE] Got you.
[AGENT][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Right?
[AGENT][NEUTRAL] This is a third party administrator, so the claim number that I just provided you with is the number that we'll be able to find a member here at American Public Life. Now if you call IMA or any other third party administrator besides American Public Life, then their policy number may be sufficient for them, but not here at American Public Life, unfortunately.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, uh
[AGENT][NEUTRAL] And the information, the benefit that I gave you is not a guarantee of benefit it's just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Huh, OK, because yeah, it says.
[CUSTOMER][NEUTRAL] OK, yeah, so, um, on the card it says call 90 degree benefits which gave me this number and then it said medical claims submission. It says EDI payer ID 64556.
[CUSTOMER][NEUTRAL] And then it had a different oh yeah that's payer ID OK.
[CUSTOMER][NEUTRAL] So this is the 90 degree benefit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh OK OK all right thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling [PII]. Have a good day. Goodbye.
[CUSTOMER][POSITIVE] Yes you too mhm.
[AGENT][NEUTRAL] Bye.