AccountId: 011433970860
ContactId: 9bafb7ac-8b61-46a9-abf0-2e846c9c2f6a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223929 ms
Total Talk Time (AGENT): 121029 ms
Total Talk Time (CUSTOMER): 83178 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/9bafb7ac-8b61-46a9-abf0-2e846c9c2f6a_20250521T17:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a provider's office. I need to get eligibility and benefits for mutual patient, please.
[AGENT][NEUTRAL] Sure, I can check eligibility and benefits for you. I'm sorry, what did you say your name was?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Of course [PII].
[AGENT][NEUTRAL] Thank you. And then, uh, do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do. It is 022 03108 M as in Mary, L as in love, 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we'll be needing to look at inpatient or outpatient uh benefits for this member.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims that outpatient benefit is $1500 per calendar year. If you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course right none of that has been used so far this year.
[CUSTOMER][POSITIVE] Perfect. And last time enough for this patient, can I have a reference number?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Last initial is [PII] And was there anything else I can help you with?
[CUSTOMER][NEUTRAL] I do have 11 last patient, but her member ID looks a little funky, so I'm not sure if it is American public life that she has.
[AGENT][NEUTRAL] Um, we could definitely try, uh, if you'll give me one moment, um, I'm gonna finish these notes and then I, I can try to see if I can find it.
[CUSTOMER][NEUTRAL] Yeah, of course.
[AGENT][NEUTRAL] OK, uh, what was the policy number that you have for the member?
[CUSTOMER][NEUTRAL] It is extremely short, so I have 1979612.
[AGENT][NEUTRAL] Uh, let's see, it might be long enough. It might just be missing the 0 at the front. Let's see.
[AGENT][NEUTRAL] What was the name for the number?
[CUSTOMER][NEUTRAL] Maybe.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have her date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][MIXED] Perfect, yes, so that is the policy number just missing the 0 at the beginning there.
[CUSTOMER][POSITIVE] You got it. Thank you so much.
[AGENT][NEUTRAL] Alrighty and so this one, are we just checking the um outpatient benefit for this member as well?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so this policy is also active, uh, effective date was [PII].
[AGENT][NEUTRAL] And let's see.
[CUSTOMER][NEUTRAL] All.
[AGENT][NEUTRAL] So outpatient benefit for this number is $1000 per calendar year and give me just a moment I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] Please
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, none of that has been used so far this year.
[CUSTOMER][POSITIVE] Perfect and same reference number correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Alrighty thank you so much [PII] you're a great help.
[AGENT][POSITIVE] Of course, absolutely, thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Likewise bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.