AccountId: 011433970860
ContactId: 90b21ff9-79c2-4e85-a6ff-bf4805db5786
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 303739 ms
Total Talk Time (AGENT): 103745 ms
Total Talk Time (CUSTOMER): 114432 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/90b21ff9-79c2-4e85-a6ff-bf4805db5786_20250402T17:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Wagner and get provider office. How are you doing?
[AGENT][POSITIVE] I'm doing well. How are you?
[CUSTOMER][POSITIVE] I'm good thank you and I do have a patient here I just need to get the member's eligibility. Would you like to help with that?
[AGENT][POSITIVE] Yes, I'll be more than happy to help you with the eligibility. And [PII], may I have a good contact number in case we're disconnected? You're welcome.
[CUSTOMER][POSITIVE] Uh huh thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] D as in Delta 47695335.
[AGENT][NEUTRAL] OK, and do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] Uh, yes, that is in front of me.
[AGENT][NEUTRAL] And on the ID card, do you see anywhere that says inpatient or outpatient policy certification number?
[CUSTOMER][NEUTRAL] Uh, there is, um, another member mentioned number mentioned that is Policy slash so I think that that is also a number, uh huh, that one is 025.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 93,220.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][POSITIVE] Uh huh you're welcome.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] That is uh [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I am showing the policy is active, it has been effective since [PII].
[CUSTOMER][NEUTRAL] [PII] current.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] What member ID should I use that? Is that 02593220 or the 4769? Which one?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] The 0259, that is the APO policy number.
[CUSTOMER][NEUTRAL] Fine, what is group number?
[AGENT][NEUTRAL] 70084.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] That's all?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What is peer?
[AGENT][NEUTRAL] Um, it's 64556.
[CUSTOMER][NEUTRAL] Fine. And uh can you confirm me walking urgent care is in network or or or out of network with this plan?
[AGENT][NEUTRAL] Um, this is a hospital indemnity policy, so that part of the policy doesn't have a network. There is the PPO network through multi-plan, however, we don't have access to their list of providers. I can give you their phone number or website to see if your provider is in network with them.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What state plan belongs to?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] What state plan belongs to?
[CUSTOMER][NEUTRAL] Like, um, patient visited the urgent care facility in [PII], uh huh.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Yes, this is [PII] for the state of issue.
[CUSTOMER][NEUTRAL] Uh-huh, that's right, and uh.
[CUSTOMER][NEUTRAL] What is mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Great thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Do you have any fax number?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEGATIVE] No fix.
[CUSTOMER][NEUTRAL] All right, let me just take a look.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] What is timely filing limit?
[AGENT][NEUTRAL] Um, there's no timely filing. You can file at any time as long as the policy is active on the data service.
[CUSTOMER][NEGATIVE] No timely filing.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Alright, what is call reference?
[AGENT][NEUTRAL] Um, there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you [PII], that's all I need, by the way, have a good time.
[AGENT][POSITIVE] You're very welcome, [PII]. You also, thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] You're welcome bye.