AccountId: 011433970860
ContactId: 87f9b4bf-4929-4349-a89b-3dd67078ee48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298500 ms
Total Talk Time (AGENT): 147941 ms
Total Talk Time (CUSTOMER): 84905 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/87f9b4bf-4929-4349-a89b-3dd67078ee48_20250516T15:25_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII]. I just want to check the eligibility of the patient. Can you please help me with that?
[AGENT][NEUTRAL] OK, [PII], you have one patient to check uh eligibility for, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. Enjoy, what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, did you say [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] Uh, my policy number is.
[CUSTOMER][NEUTRAL] 02336080. M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Enjoy any information that is provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient's name is, uh,
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] What's the first name?
[CUSTOMER][NEUTRAL] It is uh
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] [PII], it was [PII].
[AGENT][NEUTRAL] And spell the last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] [PII]. OK, thank you.
[AGENT][NEUTRAL] OK, and you're just needing eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so she is the spouse of the subscriber on the supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And because it is a supplement to their primary insurance, Joy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Provide me the pay ID number.
[AGENT][NEUTRAL] If you all will be filing a claim.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] If you're going to be filing a claim to us for her, you will also have to send us a copy of her primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] As well as the claim for review and then once we have processed the claim here at APL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We do have a portal that you should be able to check claim status in and the website for that is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And our electronic payer ID, uh, 60801.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] But again, we will have to have the primary EOB also.
[CUSTOMER][NEUTRAL] 68.
[CUSTOMER][NEUTRAL] OK. 6080.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One.
[CUSTOMER][POSITIVE] Thank you so much for uh patient with number.
[AGENT][NEUTRAL] OK, again, the payer ID is 60801.
[CUSTOMER][NEUTRAL] Patient group number?
[AGENT][NEUTRAL] The group number for this number is going to be 25921.
[CUSTOMER][POSITIVE] OK. Thank you so much. Can you provide me the correct mailing address?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Give me
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's in [PII] City, [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And what's the plan name?
[AGENT][NEUTRAL] This is a supplemental policy called Medlik.
[CUSTOMER][NEUTRAL] M
[CUSTOMER][NEUTRAL] Link. Thank you. And then provide me the, can you spell your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you, [PII]. Have a nice day. Bye-bye.
[AGENT][POSITIVE] OK, well, you're very welcome to Joy. That is all I can help you with. Thank you again for calling APO and I hope that you have a very nice weekend.
[CUSTOMER][POSITIVE] Thank you so much, ma'am. Happy weekend. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Uh-huh.