AccountId: 011433970860
ContactId: 8aa2704c-7f98-4834-9de4-0f8855201d11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 478070 ms
Total Talk Time (AGENT): 183191 ms
Total Talk Time (CUSTOMER): 223708 ms
Interruptions: 10
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/8aa2704c-7f98-4834-9de4-0f8855201d11_20250527T19:58_UTC.wav
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[AGENT][NEUTRAL] Calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh, I'm calling. Oh, hold on.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, I'm calling to verify benefits um and eligibility for a patient.
[AGENT][NEUTRAL] OK, I can help you with both benefits and eligibility. May I please get your number and your name?
[CUSTOMER][NEUTRAL] Name is [PII]. Phone number is [PII].
[AGENT][NEUTRAL] Thank you, miss. So what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] AdventHealth.
[CUSTOMER][NEUTRAL] Are you able to give me the claims address?
[AGENT][NEUTRAL] OK, and may I please have
[AGENT][POSITIVE] Yes ma'am, I can give that to you um.
[CUSTOMER][NEUTRAL] Do pig too can't be that.
[AGENT][NEUTRAL] Let's go ahead and get the member's name, date of birth, and policy number.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] I don't have the policy number, um, but everything else I have.
[AGENT][NEUTRAL] OK. All right. What's the member's name and date of birth?
[CUSTOMER][NEUTRAL] Last name is [PII], first name is [PII] Date of birth [PII].
[AGENT][NEUTRAL] OK, let me see if I can find her by her name real quick.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have a group number but uh she didn't give the.
[AGENT][NEUTRAL] The, the actual policy.
[CUSTOMER][NEUTRAL] Yeah, yeah, I keep getting back at [PII] I think.
[AGENT][NEUTRAL] OK, what is the group number?
[CUSTOMER][NEUTRAL] 117605.
[AGENT][NEUTRAL] OK, let me see if I can pull up that group.
[CUSTOMER][NEUTRAL] This one goes.
[AGENT][NEUTRAL] Does it give you a name for the group?
[CUSTOMER][NEUTRAL] Uh, [PII] Select.
[AGENT][NEUTRAL] That's the name of our, um, the type of insurance she has.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, OK, because it said plan and then it said med link so, uh, I don't know there's a payer number 60801.
[AGENT][NEUTRAL] 80 yes ma'am, do you see an inpatient or an outpatient certificate number?
[CUSTOMER][NEUTRAL] Um, uh, yeah, I don't know.
[CUSTOMER][NEUTRAL] Mm mm.
[AGENT][NEUTRAL] It would be on the front of the card. It will say inpatient.
[CUSTOMER][NEUTRAL] I don't have the card.
[AGENT][NEUTRAL] OK. Do you have her social?
[CUSTOMER][NEUTRAL] All they do is since you're that you'll be soft connect.
[AGENT][NEUTRAL] OK, let's look her up that way.
[CUSTOMER][NEUTRAL] OK, uh, tell me when you're ready.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] No, you're just gonna get like [PII]
[AGENT][NEUTRAL] OK, that's 589164528?
[CUSTOMER][NEUTRAL] Mhm 21.
[AGENT][NEUTRAL] 221 is the last number 21 OK.
[CUSTOMER][NEUTRAL] 452 1. Mhm.
[CUSTOMER][NEUTRAL] I, yeah, people still go to Spark accounts.
[AGENT][POSITIVE] OK, I think I have it pulled up now. That was what we needed.
[CUSTOMER][NEGATIVE] People don't care.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, just let me know when you're ready to take down her policy number.
[CUSTOMER][NEUTRAL] Um, I need the claims address first because I need to get out of that screen. It won't let me add the plan without all the information.
[AGENT][NEUTRAL] Oh, OK, got you.
[AGENT][NEUTRAL] Sure. OK, so the claim's mailing address is [PII].
[CUSTOMER][NEUTRAL] How much longer.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Wait, say it again, [PII] wasn't.
[AGENT][NEUTRAL] 9502, yes.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] 248,950.
[CUSTOMER][NEUTRAL] 248.
[CUSTOMER][NEUTRAL] 950.
[AGENT][NEUTRAL] And that's in [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, uh-huh, say, OK, um, [PII].
[AGENT][NEUTRAL] And then the
[CUSTOMER][NEUTRAL] Oh, hold on.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Let's do that.
[CUSTOMER][NEUTRAL] Hold on [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEGATIVE] Coco, it's not coming up here.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] It's American Public Life.
[CUSTOMER][NEUTRAL] Oh because it's abbreviated.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] Sounds like a bad 10 God.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Oh that's cool.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Try to put [PII] on the end of the zip.
[CUSTOMER][NEUTRAL] You said 90 was the last year? So download the demo right now for free for 5 hours.
[AGENT][NEUTRAL] 8950, the last four digits of the zip code if it makes you do that.
[CUSTOMER][POSITIVE] Yes, OK, yeah, yeah, that's, that was better. OK, and then, uh, if you, OK, now I'm ready for the member ID.
[AGENT][NEUTRAL] It is 251-8.
[CUSTOMER][NEUTRAL] Very
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 171.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the policy is active. Um, the effective date is [PII].
[CUSTOMER][NEUTRAL] See I get rest and then.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's current.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, um, what else do I need? Let's see.
[CUSTOMER][NEUTRAL] Is there a deductible on it?
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Very sorry yeah.
[AGENT][NEUTRAL] Let me see if she has any kind of deductible on this policy.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Yeah, they did get pretty cool.
[CUSTOMER][NEUTRAL] Yeah, it's one player game.
[AGENT][NEUTRAL] No, ma'am. She does not have a deductible.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. This is a supplemental insurance policy. It's billed uh secondary to the primary.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Uh, yeah, they added, uh, well, I think they added a while. It's called Some blocks on Star Wars for walks. You only did the dark it's so cool.
[AGENT][POSITIVE] It helps with the deductible co-pay and co-insurance only.
[AGENT][NEUTRAL] She has an inpatient benefit amount of $4050 per calendar year and then she has an.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So about outpatient. A players and you want to work.
[AGENT][NEUTRAL] She has an outpatient benefit amount of $2,025 per calendar year.
[CUSTOMER][NEUTRAL] OK. And this is American public life you said, right? OK. And what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, and then do you have a reference number or you don't do? I know some companies don't. It is.
[AGENT][NEUTRAL] Yes, you can use my name, [PII], and today's date.
[CUSTOMER][NEUTRAL] It's a delivery Mhm.
[CUSTOMER][POSITIVE] OK, and that's all I need thank you.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I'm glad I was able to help you today. I hope you have a good rest of your day and thank you for calling APL.
[CUSTOMER][NEUTRAL] So now that's all you're doing.
[CUSTOMER][NEUTRAL] How often do you do you do that?
[CUSTOMER][POSITIVE] Thanks. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][POSITIVE] You really I played.