AccountId: 011433970860
ContactId: a10ef432-14bb-4dc0-8d23-9f104205a2d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248809 ms
Total Talk Time (AGENT): 93450 ms
Total Talk Time (CUSTOMER): 97679 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/a10ef432-14bb-4dc0-8d23-9f104205a2d4_20250102T13:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] and I'm looking for a claim status.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with claim status today. What is a good callback number?
[CUSTOMER][NEUTRAL] My callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And [PII], do you have the claim number or the policy number for the patient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I have policy number. Actually, I wanted to verify the eligibility also.
[AGENT][NEUTRAL] I can help you with that as well, [PII]. What is the policy number for the patient?
[CUSTOMER][NEUTRAL] OK. It's 01221549 M as in Mary, L as in Lima, then number 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you with eligibility and claim status for [PII]. I'm showing that her policy is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Mhm. And the policy is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the data service for the claim status?
[CUSTOMER][NEUTRAL] OK. So, I also wanted to know, like, are you primary for this patient?
[AGENT][NEUTRAL] We're actually secondary to the major medical coverage of the policyholder.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You are the secondary, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And is, is there any primary insurance?
[AGENT][NEUTRAL] They do have primary insurance. I can provide that information to you or the name. I'm showing that Florida Blue is the primary.
[AGENT][NEUTRAL] Carrier.
[CUSTOMER][NEUTRAL] Florida Blue is the primary.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK. But uh Florida Blue is denying the claim stating that just allow me a second. Let me check what they are seeing.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Like missing plan information uh for the insurance.
[AGENT][NEUTRAL] Yeah, I don't know, but we are secondary.
[CUSTOMER][NEUTRAL] You are secondary, OK, no issue. Just allow me a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when was the, this sort of thing, coordination of benefits were updated?
[AGENT][NEUTRAL] On the effective date of [PII].
[CUSTOMER][NEUTRAL] OK. [PII]. After that, it's not updated?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. Allow me a second.
[CUSTOMER][NEUTRAL] [PII] 16. OK. So may I please have the call reference number?
[AGENT][NEUTRAL] The call reference number is my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] And [PII], it was a pleasure to assist you with that eligibility for [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, [PII]. I'm done for today.
[AGENT][POSITIVE] Well, thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. Have the same and have a great New Year.
[AGENT][POSITIVE] Thank you, [PII]. I hope you have a wonderful new year as well and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye-bye.