AccountId: 011433970860
ContactId: 88bffc4c-b179-4746-8c7b-10b9e5380906
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1007119 ms
Total Talk Time (AGENT): 307335 ms
Total Talk Time (CUSTOMER): 570561 ms
Interruptions: 7
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/88bffc4c-b179-4746-8c7b-10b9e5380906_20250514T15:32_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm, I'm [PII] calling from Baptist Health. How are you today?
[AGENT][POSITIVE] Hey [PII]. I'm good. How are you?
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] Hi how's it going?
[AGENT][POSITIVE] It's going great, [PII]. I have no complaints. How are you doing today?
[CUSTOMER][NEUTRAL] I'm OK, thank you, [PII]. Um, can you please help me with 2 members per patient, uh, eligibility and benefits?
[AGENT][NEUTRAL] Of course, [PII]. Can I have the spelling of your name and the callback number for you?
[CUSTOMER][NEUTRAL] Yes, spelling my name is [PII] Last name is [PII].
[AGENT][NEUTRAL] Thank you and what's the callback number, [PII]?
[CUSTOMER][NEUTRAL] Oh OK, [PII].
[AGENT][NEUTRAL] Can I have that member's policy number?
[CUSTOMER][NEUTRAL] OK, yeah, their policy number. Let me make sure, hold on.
[CUSTOMER][NEUTRAL] OK. It's 02432942 ML8.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth for me, [PII]? I'll be able to assist you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Born on [PII].
[AGENT][NEUTRAL] You're calling to verify benefits eligibility for outpatient services.
[CUSTOMER][NEUTRAL] Yes, outpatient urgent care. Does she have that coverage?
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active.
[CUSTOMER][POSITIVE] OK, perfect. So she does have that coverage. OK, perfect, and she's a subscriber?
[AGENT][NEUTRAL] And [PII], outpatient benefits is 5, she is, and she has $5000 per calendar year for outpatient services and this is not a guaranteed benefits just a disclaimer of the policy's coverage.
[CUSTOMER][POSITIVE] Perfect, thank you. OK. And the name of her, the employer is G I L E C A International Corp?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and the group number is 22525?
[AGENT][NEUTRAL] Give me one moment and I can verify that for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And could you repeat that again? You asked me.
[CUSTOMER][NEUTRAL] 22525 is the group number?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK perfect OK and she's and she's the subscriber, right?
[AGENT][POSITIVE] Yes, that is correct. [PII] is the subscriber.
[CUSTOMER][POSITIVE] Perfect. OK.
[CUSTOMER][NEUTRAL] Your name is [PII] and your reference number is your name in today's date.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, let me go ahead and save this one and we can go on to the next one. I can't believe it's already the middle of May.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Time goes by so fast.
[AGENT][NEUTRAL] The year.
[CUSTOMER][NEUTRAL] Right. Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let's see here, yeah, it's, I'm about to hit on Tuesday, yes, Tuesday, yeah, my, my one year anniversary with the company. I can't believe it already.
[AGENT][POSITIVE] Oh, congratulations.
[CUSTOMER][POSITIVE] Thank you. I, I just was like, wow, you know, the [PII], so that's Tuesday, right? The [PII] is Tuesday, yeah.
[AGENT][NEUTRAL] Um, I think it is cause my niece graduated on the [PII].
[CUSTOMER][POSITIVE] Oh, congratulations to her too.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK and then spoke.
[CUSTOMER][NEUTRAL] You people are like wow, one year I'm like I know I just I am just like in shock.
[CUSTOMER][NEUTRAL] So I just
[CUSTOMER][NEUTRAL] You know it's just so crazy how your life can change when you switch to a new thing, a new position, a new job, you know, it's just like and you think about it it's like, yeah, it's gonna be scary, but I mean you you're like, oh my [PII] already, you know, it's just like wow.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um, from APL and verified patients gap, or gap medical policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So what's the next policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yep, let me go ahead and save.
[CUSTOMER][NEUTRAL] Next one is, let me see.
[CUSTOMER][NEUTRAL] OK, it's loading.
[CUSTOMER][NEUTRAL] OK, the next one, let me pull him up where you go.
[CUSTOMER][NEUTRAL] Oh, his name is here.
[CUSTOMER][NEUTRAL] OK. Where did he go? OK. Oh yeah, here he is.
[CUSTOMER][NEUTRAL] OK, his member ID?
[CUSTOMER][NEUTRAL] It's gonna be let's see.
[CUSTOMER][NEUTRAL] OK, 02354552 ML 7.
[AGENT][NEUTRAL] And what is this member's name, [PII]?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] So let me give you the correct policy number for [PII].
[CUSTOMER][NEUTRAL] Oh, OK, hold on one second, let me see.
[CUSTOMER][NEUTRAL] OK, hold on, hold on, hold on, actually give me one second, hold on, I gotta fix something myself too, hold on.
[CUSTOMER][NEUTRAL] 84 let me put the wrong address. Hold on.
[CUSTOMER][POSITIVE] Great
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I tell people all the time you put the wrong addresses it gets billed wrong. Hold on one second for the primary one second 305-55.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sorry, OK, let me just double check I put that right, so his, his date of service was [PII].
[AGENT][NEUTRAL] No [PII].
[AGENT][NEUTRAL] Of 25.
[CUSTOMER][NEUTRAL] So is that at 25, yeah?
[AGENT][NEUTRAL] So this policy number that I'm gonna, I'm going to provide you has been active since [PII].
[CUSTOMER][NEUTRAL] Um, oh my goodness, so this one, the one I gave you, when did that term.
[AGENT][NEUTRAL] Mm, I forgot the policy number, but I can look again.
[CUSTOMER][NEUTRAL] No, it's OK, it's OK. Well, what is the new one?
[AGENT][NEUTRAL] It is 2431069.
[CUSTOMER][NEUTRAL] Oh my God, these people, I tell you.
[AGENT][NEUTRAL] 2431069
[CUSTOMER][NEUTRAL] And they don't know they.
[CUSTOMER][NEUTRAL] 69 perfect and same thing, does he have outpatient urgent care coverage?
[AGENT][NEUTRAL] $2000 2000 dollars per calendar year for outpatient services, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage. The policy has been active since [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, great. So he does have that outpatient urgent care coverage. That's good to know. Um, OK, what is the group name?
[AGENT][NEUTRAL] The group name, it should be the same Southern.
[AGENT][NEUTRAL] Bernay's Inc.
[CUSTOMER][NEUTRAL] I'm sorry, say one more time.
[AGENT][NEUTRAL] Suttering, Sutter, S U T T O N, Sutton, Sutton. I'm gonna say what.
[CUSTOMER][NEUTRAL] S U T H.
[AGENT][NEUTRAL] Mm. S as in Sally, no, S as in Sally, U as in umbrella, T as in Tom, T as in Tom, O as in orange, N as in Nancy.
[CUSTOMER][NEUTRAL] ORN you said?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh, certain, OK.
[AGENT][NEUTRAL] It is [PII], it's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] 20665.
[CUSTOMER][POSITIVE] OK thank you so much that's a.
[CUSTOMER][NEUTRAL] 20665 OK perfect and [PII] is the subscriber?
[AGENT][NEUTRAL] Yes, he is.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, let me see this one.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] All right, perfect.
[AGENT][NEUTRAL] So do you work in billing [PII]?
[CUSTOMER][NEUTRAL] No, I just, so I just verify patient eligible bill and benefits and then what happens is, is we work off as like a work list, right? So we get, we, we receive patients information. OK, I'll explain the process. So what happens is we have, we're only located here in [PII], right? And we have people we have different sites like Express Care, diagnostic, urgent care, right, different facilities, right? Patients go to these different type of facilities, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, but what happens is we have registered.
[CUSTOMER][NEUTRAL] That work at our sites to register patients through Zoom. They collect the information of the patient and then they put it into the database, our databases, then me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have to go back in right and make sure it was done correctly and figure out, OK, what's correct. Are the patient, you know, and figure out what's going on with the patient's plan are they covered? Are they not covered, you know what I'm saying? and figure out what's correct so that way it's done properly and they can go to billing because the goal is for us to to get paid.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Is that does that make sense?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Makes perfect sense.
[CUSTOMER][NEUTRAL] Yeah, so you know, so I'm not billing, but I, we, I guess we kind of help with billing, but like I said, I have to make sure the information is correctly. If not, that's why I tell people you guys ask questions. I had someone today say, Hi team, this is where we go verify First Health. I'm like, that's the network. That's not the insurance, that's the network. It's like I'm, you know, I'm, I don't tell people what to do because I know people do different jobs.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You know?
[CUSTOMER][NEUTRAL] Uh-huh, but yeah, so I'm not billing, no.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I just try my best to give 100% every day.
[AGENT][NEUTRAL] Right, that's all you can do.
[AGENT][NEUTRAL] So you work from home?
[CUSTOMER][NEGATIVE] Show up every day. I work from home. um, yeah, so all the offices are are south. They're all in [PII]. I don't wanna go to [PII], no.
[AGENT][NEUTRAL] Well, so you, you always worked from home, so this is a remote, remote position.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, do you, do you do?
[AGENT][NEUTRAL] Mhm, I do. I do.
[CUSTOMER][NEUTRAL] You like it?
[AGENT][NEUTRAL] Yup, I do. I do. I've been remote for almost 8 years. It may be 8 years.
[CUSTOMER][POSITIVE] I love it.
[CUSTOMER][POSITIVE] Oh really? Oh wow.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And yeah, I, I like I said, I started with this company when [PII] will be one year and but previously I worked for Second and Healthcare and I worked in dental.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Did you like it?
[CUSTOMER][NEUTRAL] Yes with the dentist.
[CUSTOMER][POSITIVE] I like wearing here. I, I am here better.
[CUSTOMER][NEUTRAL] So it's just yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So how did you get the job through a temp agency?
[CUSTOMER][NEUTRAL] I was going through so much before.
[CUSTOMER][NEUTRAL] Which one?
[AGENT][NEUTRAL] Where are you at now?
[CUSTOMER][NEUTRAL] This, so.
[CUSTOMER][NEUTRAL] The other one I was hired as a temp with Cigna. I was a contractor, right? That's how Cigna does things. I was a temp for 3.5 years.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] A Cigna, right, so I was a contractor, but I just, I always tell people I work for Cigna, even though I didn't, right? And what happened is I know someone who I love [PII]. He's like my family, he's the vice president of the company I'm at now, and he helped get a job. He helped me get a job where I'm at now.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK. So how did you get, so did you have to apply online or was it?
[AGENT][NEUTRAL] Through temp agency.
[CUSTOMER][POSITIVE] Yeah, it was, I'm telling you, he was, it's, he's he's the sweetest, he makes my heart melt, you know, as soon as the position was posted, he took it down so that way I could just apply.
[AGENT][NEUTRAL] Got you. What is the name of the company that you work for?
[CUSTOMER][NEUTRAL] And that way
[CUSTOMER][NEUTRAL] Say again.
[AGENT][NEUTRAL] What's the name of the company that you work for?
[CUSTOMER][NEUTRAL] So the name of the company is called Baptist Health, right? And the name of the house, the facilities is that as we build is called South Miami, right, the Baptist Health is just a [PII].
[AGENT][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Actually
[CUSTOMER][NEUTRAL] Thing right, it's not like a Cigna, it's not Adna, it's not unit it's just a little [PII] based thing.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you actually work for the facility itself.
[AGENT][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Say again.
[AGENT][NEUTRAL] You actually work for the facility itself.
[CUSTOMER][NEUTRAL] Right, right, we work for, I work for Baptist Health. I'm not a contractor. Like before, like I told you I was a contractor, right? I didn't work for Cigna. I actually full time benefits more money working for the company.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Right. And then the best thing is you work from home.
[CUSTOMER][POSITIVE] Thank God
[AGENT][NEUTRAL] So is it like a telehealth position?
[CUSTOMER][NEUTRAL] Uh, how, how
[CUSTOMER][NEUTRAL] Say again.
[AGENT][NEUTRAL] Is it a telehealth position?
[CUSTOMER][NEUTRAL] No, no, no, this is, so my role is like an authorization and the title of the job is authorization associate.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, so that's, that's the name of the, of the role, right, but basically, right, yeah, I, I like it, you know, where I am. I don't know about you, there's a lot of chance.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] You sound like you're happy.
[CUSTOMER][NEUTRAL] I, I don't know. I feel like, I don't know if it's true, but I feel like I haven't had one bad day yet. I don't know.
[AGENT][POSITIVE] That's good. And you've been there a year, so that's good.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] I made it one year almost.
[AGENT][POSITIVE] Yeah, that's good.
[CUSTOMER][NEUTRAL] I just, you know, how, how about you, how about you? How long have you been with American Pop Life?
[AGENT][NEUTRAL] I've been with American Public Life 8 years.
[CUSTOMER][POSITIVE] Wow, that's amazing. You must love it there.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] It's, it's such, yeah, it's OK. I, I enjoy interacting with individuals like you.
[AGENT][NEUTRAL] In assisting them.
[CUSTOMER][POSITIVE] Oh you're sweet.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yup, and it's the best part is you work from home, you don't have to fight traffic.
[CUSTOMER][POSITIVE] Oh you're sweet.
[AGENT][NEUTRAL] Um, you don't, you save on gas money, save on lunch money cause you at home, so.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][MIXED] Well, it's so funny and we always have to have our camera on, so at least my hair has to be done, but the thing is I'm so short they can barely see my head they can barely see my head. They can barely see my body. My head barely fits in the camera.
[AGENT][NEUTRAL] Oh, see, we don't.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] See, we don't have to have on the phone unless there's a meeting or something.
[CUSTOMER][NEUTRAL] OK, like.
[CUSTOMER][NEUTRAL] Yeah, but I'm literally that sure. I, I just forget it.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEGATIVE] You know, my head barely fits.
[CUSTOMER][NEUTRAL] 5 ft.
[AGENT][POSITIVE] You're funny.
[CUSTOMER][NEUTRAL] OK, so I was just like forget it, forget it, but I don't like, I don't know, they like the camera on. I just I like always know, oh, OK, at least I have to have my hair done at least for the camera, but forget the outfit because it's I'm too short.
[AGENT][NEUTRAL] Oh, OK. Well.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well, congratulations on your year if I don't speak with you on Tuesday cause I know I was out a couple of days cause I had COVID, so, um.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] Oh no.
[AGENT][NEGATIVE] Yeah, I wasn't feeling too well. Thursday until, yeah, I came back to work yesterday. I wasn't feeling too good. Um, I think Thursday, Friday, Saturday, Sunday, and Monday, and I came back to work yesterday. I just, I feel horrible, but I'm back. I'm not normal, but I'm getting back to myself, so my voice is still stretchy and the headaches.
[CUSTOMER][POSITIVE] I hope you're OK.
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Ah.
[CUSTOMER][POSITIVE] Well, take it easy, take it easy, one day at a time, listen to your body one day at a time.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes. It was a pleasure speaking with you, [PII], and congratulations on your year if I don't speak with you next Tuesday.
[CUSTOMER][POSITIVE] Thank you. uh, thank you.
[AGENT][POSITIVE] And thanks for calling APL and you have a great day. Thank you. You too. Goodbye.
[CUSTOMER][POSITIVE] All right, have a great day.
[CUSTOMER][NEUTRAL] Bye bye.