AccountId: 011433970860
ContactId: 87d81184-e69b-4ecd-96a5-38d8bcb977fb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299309 ms
Total Talk Time (AGENT): 98075 ms
Total Talk Time (CUSTOMER): 156154 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/87d81184-e69b-4ecd-96a5-38d8bcb977fb_20250307T20:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. We're the provider. I'm just calling for eligibility for a member.
[AGENT][POSITIVE] I'm sure, [PII] I can assist you with benefits. Um, first, I'll need a good callback number.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, 1,306,730 ML 8.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. And just let me advise you.
[CUSTOMER][NEUTRAL] I have a question for you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, I was gonna say, yeah, I'm just curious. I had a coworker who said that she verified this, and then I guess she didn't verify properly. I'm not surprised. Do you have someone in there that names [PII]?
[CUSTOMER][NEUTRAL] You know someone named [PII]?
[AGENT][NEUTRAL] Yeah, there's
[AGENT][NEUTRAL] There's several of them, yeah.
[AGENT][NEUTRAL] Do you have the last name?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Yeah, I apologize. I'm not sure which one that is.
[CUSTOMER][NEGATIVE] No, it's OK it's not her fault it's my coworker's fault, not verifying it correctly. She didn't put the correct plan code. She didn't put the correct address, nothing, no.
[AGENT][NEUTRAL] Oh wow. Well, I try to correct all that. Just let me advise you the verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So this is, this is her secondary because Blue Cross Blue Shield is primary, so this is her secondary so I'm gonna this is a group plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] This is great.
[AGENT][NEUTRAL] Yes, it is. You need the group number?
[CUSTOMER][NEUTRAL] I'm gonna let me just put the plan together because they, they left it as they didn't even change the plan code my coworker, so I'm gonna put American public actually no we have a plan for that. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think we I think we do hold on.
[CUSTOMER][NEUTRAL] American, hold on.
[CUSTOMER][NEUTRAL] We do have a plan for that.
[CUSTOMER][NEGATIVE] I know we do. I'm like, uh, uh, is it when people I hate to, that's not [PII]'s fault, but when people just do whatever, you know, it, it, it bothers me.
[AGENT][NEUTRAL] Right, I understand.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Um, what is the, what is the group name?
[AGENT][NEUTRAL] Um, the group name is.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] It's V like Victor.
[AGENT][NEUTRAL] Then ME Media Incorporated.
[CUSTOMER][NEUTRAL] Yeah, INC, OK, hold on one second.
[AGENT][NEUTRAL] Yes. Sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, because it's not, it's not, hold on, it's not Paycheck Business Solutions, right?
[AGENT][NEUTRAL] No, it's not.
[CUSTOMER][NEUTRAL] OK, hold on one second, I'm gonna check something.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] OK. So, it is.
[CUSTOMER][NEUTRAL] V N E is one word, Media Inc.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, what is the group number, EV?
[AGENT][NEUTRAL] The group number is 16291.
[CUSTOMER][POSITIVE] OK, perfect. OK, very easy.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, we have a plan for this and she didn't even put the plan. It's just, uh, it's OK. I'm here and she's and she's E E V I E, right?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] [PII] and my last initial is [PII] and today's date, that will be your reference number.
[CUSTOMER][NEUTRAL] Alright, and then she's the subscriber, right?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yes, she is. She's the only one on the policy.
[CUSTOMER][POSITIVE] OK, perfect. Now it's texting and correcting you now and can go to billing now.
[AGENT][NEUTRAL] OK. And then what uh type of services as far? Is it inpatient or outpatient or an office visit?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It was for outpatient urgent care, but we don't need it. We don't need any co-pay because she has she has Blue Cross Blue Shield is primary.
[AGENT][NEUTRAL] OK, got you. OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] So we're all set.
[CUSTOMER][NEUTRAL] Um, no, not for now until we call, not until we call you guys back.
[AGENT][POSITIVE] OK. Well, I thank you again, [PII], for calling APL. You have a great weekend. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] I thank you for the help have a great weekend bye bye.