AccountId: 011433970860
ContactId: a38ebde2-3d32-4371-9075-3e5c8be78b89
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 602119 ms
Total Talk Time (AGENT): 167981 ms
Total Talk Time (CUSTOMER): 343064 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/a38ebde2-3d32-4371-9075-3e5c8be78b89_20250403T15:09_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 [PII]. Good morning. My name is [PII], and I'm calling from United Health Group coordination of Benefits department, and I'm calling to verify members eligibility perit number so that we can coordinate benefits correctly for quality assurance this call may be monitored and recorded.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with that eligibility. What is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, I mean, for the insured?
[CUSTOMER][NEUTRAL] Uh, yes, uh, by the way, [PII], uh, I will be verifying two members. Is that OK?
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] I would be happy to assist you with 2 members.
[CUSTOMER][POSITIVE] OK, thank you. OK.
[CUSTOMER][POSITIVE] I see, thank you so much. OK, the first, uh, policy number for this number is 018.
[CUSTOMER][NEUTRAL] 261-91.
[CUSTOMER][NEUTRAL] M as in Mary. L for Larry, and 7.
[AGENT][NEUTRAL] Thank you, [PII]. And the patient's name or the insured's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. The last name spelled as [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] Now, I'm showing that she is a dependent and the policy is active with the effective date of [PII].
[CUSTOMER][NEUTRAL] [PII] and is this the original effective date?
[AGENT][NEUTRAL] Let's see if they have cover coverage prior to that.
[AGENT][POSITIVE] It is the original effective date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much for that and can you also provide me the name of the specialty pharmacy vendor?
[AGENT][NEUTRAL] Uh, pharmac, uh, pharmacy vendor, uh, pharmacy benefits are not included on the secondary gap policy.
[CUSTOMER][NEUTRAL] I see. OK, thank you and.
[CUSTOMER][NEUTRAL] Is the policy through an employer?
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] And may I know the name of the group, please?
[AGENT][NEUTRAL] The group name is Millennium Management.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Millennium management. OK, thank you, and the group number.
[AGENT][NEUTRAL] 23806.
[CUSTOMER][NEUTRAL] 06 thank you and you've mentioned that a while ago that.
[CUSTOMER][NEUTRAL] [PII] is only a child dependent.
[AGENT][NEUTRAL] Um, she is.
[AGENT][NEUTRAL] Let me see if she's the.
[AGENT][NEUTRAL] She is the spouse of the policyholder.
[CUSTOMER][NEUTRAL] OK, I see, so she's a spouse dependent, OK.
[CUSTOMER][NEUTRAL] Mhm and can you able to provide me the name of the spouse.
[AGENT][NEUTRAL] I'm sorry, I'm not able to give that information. Can you, if you can verify his date of birth, I can give you.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Information.
[CUSTOMER][NEUTRAL] OK, let uh let me see if I can have it on our file.
[AGENT][NEUTRAL] Or if you have it I can verify that if he's the policy holder.
[CUSTOMER][NEUTRAL] OK, fine.
[CUSTOMER][NEUTRAL] I see, OK.
[CUSTOMER][NEUTRAL] May I confirm it's the, uh huh, just give me a minute.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] I, I see. Can you, can you confirm to me if the name of the spouse is [PII]?
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] He is the policy holder.
[CUSTOMER][NEUTRAL] I see. I got it.
[CUSTOMER][NEUTRAL] He's the policy holder. OK, thank you.
[CUSTOMER][NEUTRAL] And um aside from [PII], is there a child dependent here or only the two of them?
[AGENT][NEUTRAL] There are 2 children dependent.
[CUSTOMER][NEUTRAL] Two children dependent on the policy or uh huh, OK.
[CUSTOMER][NEUTRAL] OK, one moment also.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] Please confirm to me if the child are [PII] and [PII].
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][NEUTRAL] OK, I see. And do they have the same effective date?
[AGENT][NEUTRAL] They do. Excuse me.
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] They do.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They do alright, OK, uh, I think I'm done with this call for this particular member. Can you are you able to provide me a call reference number for this one for documentation purposes?
[AGENT][NEUTRAL] It would be my name, my name in today's date.
[AGENT][NEUTRAL] And I spell my name [PII]
[AGENT][NEUTRAL] First initial last name, [PII].
[CUSTOMER][NEUTRAL] OK, thank you, uh, that would be also the call reference number for the next number, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, OK, thank you. I will now go over to the next number. Uh, please let me know uh once you're ready.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] OK, um, policy number is 02419107.
[CUSTOMER][NEUTRAL] M as in Mary, L for Lima, and number 8.
[AGENT][NEUTRAL] Alright, I am ready whenever you are. I've got that policy pulled up in the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] Yes, it's Pas [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] And I'm showing the effective date on this policy is [PII] and the policy is active.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I see. OK. And also this is the original effective date [PII].
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, thank you and same question, do they have a pharmacy coverage for this one?
[AGENT][NEGATIVE] No pharmacy coverage.
[CUSTOMER][NEUTRAL] OK, and can you provide me the name of the group if this is through an employer?
[AGENT][NEUTRAL] Mhm. The group name is Credit Corp and that's C R E D I C O R P capital LLC.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I see. OK, thank you, and the good number is?
[AGENT][NEUTRAL] 259-69.
[CUSTOMER][NEUTRAL] 259-69 OK and is this an individual or family plan?
[AGENT][NEUTRAL] Family.
[CUSTOMER][NEUTRAL] Family plan, OK. And may I verify?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] If the policy holder is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Soto or
[AGENT][POSITIVE] [PII], that's correct.
[CUSTOMER][NEUTRAL] So [PII] is
[CUSTOMER][NEUTRAL] A father or a spouse?
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] The father.
[CUSTOMER][POSITIVE] But, OK, thank you. And also, aside from uh from past.
[CUSTOMER][NEUTRAL] Is there another child dependent here?
[AGENT][NEUTRAL] There is. It's family coverage.
[CUSTOMER][NEUTRAL] And the name
[CUSTOMER][NEUTRAL] Yes, and the name is [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and is there a spouse dependent?
[AGENT][NEUTRAL] There is.
[CUSTOMER][NEUTRAL] There is, so all of them, there are 4 members on this policy.
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] Alright, alright, I think that.
[CUSTOMER][NEUTRAL] I got all the information that I need uh for this call [PII] and as you said a while ago uh I will be using the reference number as your name and last name and the day to day, right?
[AGENT][NEUTRAL] That's correct for the reference number.
[AGENT][POSITIVE] And [PII], it has been a pleasure to assist you with that eligibility. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Uh, that would be all, and thank you so much, [PII], for the assistance. Have a great day and enjoy the rest of your day. Bye for now.
[AGENT][POSITIVE] My pleasure. I hope you, oh yeah, I hope you have a wonderful day as well. [PII]. Thank you for calling APL. Take care.
[CUSTOMER][POSITIVE] And take care.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.