AccountId: 011433970860
ContactId: 9e4b8c2f-9996-4a95-9bab-cce1b5c76d9e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 434670 ms
Total Talk Time (AGENT): 185698 ms
Total Talk Time (CUSTOMER): 132498 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/9e4b8c2f-9996-4a95-9bab-cce1b5c76d9e_20250303T16:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi Ms. [PII], good morning. I was calling to get some help with verifying eligibility for a patient.
[AGENT][NEUTRAL] OK, you just need eligibility. You do not need benefits.
[CUSTOMER][POSITIVE] Yes, ma'am, that's correct.
[AGENT][NEUTRAL] As well, yes, ma'am, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII] last initial [PII]
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] I have 02389232.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] Soto, [PII].
[AGENT][NEGATIVE] OK, thank you. So now on this policy he had been a subscriber, but this policy actually termed 101 of 2024, and he does not have any other coverage with us beyond that point. It was active from [PII], and again it turned on 10-12024.
[CUSTOMER][NEUTRAL] Oh, OK, just a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alrighty, and then a reference number?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[AGENT][NEUTRAL] And if you need the first initial, [PII] to my last name, it's [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Alrighty, Ms. [PII]. And then may I have your help with another patient?
[AGENT][NEUTRAL] that you're also needing eligibility on?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am, just one moment please.
[CUSTOMER][POSITIVE] No problem thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And the next policy number?
[CUSTOMER][NEUTRAL] Uh, the next policy number is 0161.
[CUSTOMER][NEUTRAL] 1693.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And the same with this one, any information that I provide would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] We have [PII] [PII].
[AGENT][NEUTRAL] Maybe I misheard the number.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] What is the name again? Yeah that you said.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you gave me 0, I may have misheard it. 01611693.
[CUSTOMER][NEUTRAL] Yes, ma'am, that's what I have showing here.
[AGENT][NEUTRAL] OK. There's no one on that this policy by that name.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] And hospital benefits 0101611693.
[CUSTOMER][NEUTRAL] That's what it shows. I'm looking at the actual card.
[AGENT][NEUTRAL] And he's
[AGENT][NEUTRAL] Mhm. And his name is on the ID card.
[CUSTOMER][NEUTRAL] It says, uh, [PII] has his name on it.
[CUSTOMER][NEUTRAL] Um, group number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The top number is is smudged, but the, the in and outpatients are the same numbers, right? Just the last ML 8 and ML something 9 I think.
[AGENT][NEUTRAL] Yeah, but you're, OK, so you're saying that the person.
[AGENT][NEUTRAL] The person's name.
[AGENT][NEUTRAL] Is on the ID card that you're giving me as the patients?
[CUSTOMER][NEUTRAL] On the actual, yes, yes, ma'am.
[AGENT][NEUTRAL] OK, with 01611693?
[CUSTOMER][NEUTRAL] No, no. 0161. Yeah, you said it right. 01611691639. I'm sorry.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so you're OK. So let me try that one. You were giving me 93.
[CUSTOMER][NEUTRAL] 39.
[CUSTOMER][NEGATIVE] Yes, they put it in wrong.
[AGENT][NEUTRAL] And that's
[AGENT][NEUTRAL] Not correct. OK. Not for that person. So give me just a second.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] No problem, take your time.
[CUSTOMER][NEUTRAL] Yeah, they put it in the system wrong, so I fixed it. 01611639.
[CUSTOMER][POSITIVE] 169 perfect yes.
[AGENT][NEUTRAL] OK. And again, the date of birth for your patient?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this supplemental policy and it is active crystal with an effective date of [PII].
[AGENT][NEUTRAL] And this is one of those policies you're probably already familiar with this now, but because it's a supplement when the claim is submitted to APO we do have to have the primary insurance company's explanation of benefits. Uh huh, and then we have our portal that you all should be able to check claim status in once we've processed our claim by going to [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Insurance, yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. Thank you so much for that information. That is all I need today.
[AGENT][NEUTRAL] Well, you are
[AGENT][POSITIVE] OK. Well then, if that's all I can help you with, thank you again for calling APL. I'm glad we solved our mystery.
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] So I hope you have a great day.
[CUSTOMER][POSITIVE] You do the same. Have a good day. Enjoy your work week. Thank you. Bye bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. You too. Bye, [PII].