AccountId: 011433970860
ContactId: a210fafa-3439-447d-8e9e-f89551a5fc63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280260 ms
Total Talk Time (AGENT): 125198 ms
Total Talk Time (CUSTOMER): 110394 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/a210fafa-3439-447d-8e9e-f89551a5fc63_20250508T14:29_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh hi, my name is [PII]. I'm calling up from I'm calling from Kids Medical Services.
[AGENT][NEUTRAL] I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] I just want to check this.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][POSITIVE] OK, [PII]. Thank you. And how can I help you today?
[CUSTOMER][NEUTRAL] I just wanna check the eligibility for this patient.
[AGENT][NEUTRAL] OK, you're needing only eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yeah, and the address where I can send the claim?
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number [PII].
[CUSTOMER][NEUTRAL] It's 02255724 M as in Mary, L as in Lamp 8.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][POSITIVE] OK, you're welcome.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today 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] The patient's name is [PII].
[CUSTOMER][NEUTRAL] And then his date of birth is [PII].
[AGENT][NEUTRAL] OK, I'm so
[CUSTOMER][NEUTRAL] I don't know if she's uh she's added.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In the policy.
[AGENT][NEUTRAL] OK, and tell me his name one more time.
[CUSTOMER][NEUTRAL] He's a newborn.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] And date of birth again?
[CUSTOMER][NEUTRAL] It's a newborn.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what, who is the subscriber on this policy?
[CUSTOMER][NEUTRAL] The subscriber is [PII].
[AGENT][POSITIVE] OK, so thank you.
[CUSTOMER][NEUTRAL] I believe he's a grandfather.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So, again, any excuse me.
[AGENT][NEUTRAL] I'm so sorry about that. Any information, [PII] is a verification and not a excuse me a verification of benefits and not a guarantee of payment. So this child is not covered under this policy at this time.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] It's not covered. Uh, OK. Because it's under grand grand grandfather. OK. OK. The baby, baby, not covered. OK. OK. OK. And then what's your name again?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Yes, ma'am. The child is not covered.
[AGENT][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] Again, my name is [PII] and my name along with today's date would be your call reference number.
[CUSTOMER][NEGATIVE] And then, OK, by the way, doesn't matter it's not covered for that. What is the correct address for this one because I really need to get a denial that thing.
[AGENT][NEUTRAL] You're needing the claims name?
[CUSTOMER][NEUTRAL] Um, the AP, APL? Yes, uh-huh, with PO box.
[AGENT][NEUTRAL] The claims mailing
[AGENT][NEUTRAL] PO Box 248,950, [PII] City, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK. OK, that's it. Thank you so much.
[AGENT][NEUTRAL] And for future reference, yes, and just for future reference if you do submit a claim with us once it has been processed and reviewed, we do have a portal that you should be able to check claim status in and the website for that is secured. [PII].
[CUSTOMER][NEUTRAL] OK, yes, uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much OK.
[AGENT][POSITIVE] OK, thank you very much for calling APL if that is all I can help you with, and I hope you have a great day, [PII].
[CUSTOMER][POSITIVE] You, you too. Thank you so much. OK, bye-bye.
[AGENT][POSITIVE] Thank you. Yes, ma'am. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.