AccountId: 011433970860
ContactId: a47e4cf9-5760-411d-bbc0-9c57db367893
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 384179 ms
Total Talk Time (AGENT): 184027 ms
Total Talk Time (CUSTOMER): 142250 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/a47e4cf9-5760-411d-bbc0-9c57db367893_20250325T15:56_UTC.wav
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[AGENT][NEUTRAL] I'm contacting. My name is. May I help you?
[CUSTOMER][NEUTRAL] Hello, yes, ma'am. I'm just, my doctor's office told me to call. Uh, they scanned this insurance card and I came to my visit. Then on my checkout, she said the eligibility status report.
[CUSTOMER][NEGATIVE] Status error payer is not supported.
[CUSTOMER][NEUTRAL] For electronic eligibility, payer ID is invalid.
[CUSTOMER][NEUTRAL] What does that mean?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not really sure. Um, sir, what is your policy number, sir?
[CUSTOMER][NEUTRAL] OK, hang on one second.
[AGENT][NEUTRAL] It might begin with a 01 or 02.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Maybe we could look at it by your name. Um, how do you spell your last name, sir?
[CUSTOMER][NEUTRAL] I have a medical ID number.
[AGENT][NEUTRAL] And, and what is that, please?
[CUSTOMER][NEUTRAL] Oh, OK. Here's the policy number.
[CUSTOMER][NEUTRAL] It's 02580603.
[AGENT][NEUTRAL] Thank you. And if I could verify your name, uh date of birth, and a phone number, please.
[CUSTOMER][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you very much. And this is for your doctor's office, is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this uh appears to be through your employer.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And let me see what we have here.
[AGENT][NEUTRAL] It looks like management uh services uh is your employer and what they do is they provide us with an electronic spreadsheet each week.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Just showing us that you're [PII] that you're still with the program and we haven't gotten that this week so that's what we're looking for. So there, there's an electronic spreadsheet that that your employer sends to us um and we're just waiting for that. So I'm showing that your policy is active, it's just that I, I'm just showing that for this week we need that that spreadsheet from your employer and we have contacted them we, you know, we are waiting for them to give that to us, but that might possibly be what is going on.
[CUSTOMER][NEUTRAL] OK. Well, that kept me from, you know, being able to use the insurance, my doctor visit.
[AGENT][NEUTRAL] I'm very sorry, sir, that normally they go ahead and send it to us. Um, is there any way that you could talk to your employer about getting that because that's all we're needing is just that, that um that electronic spreadsheet just.
[CUSTOMER][NEUTRAL] I'll have to, you know, now I have to.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I mean, I can try, you know, it's just.
[CUSTOMER][NEUTRAL] I can try to call them.
[CUSTOMER][NEUTRAL] Electronic spreadsheet of of insurance.
[AGENT][NEUTRAL] Well, yes sir, what they do is they, they verify, yes sir, what they do is they, your employer sends us something each week um just verifying that that you're still with the program and that's what we're, that's what we're waiting for.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Can you call him?
[AGENT][NEUTRAL] Uh, no, sir, we, we send it to them electronically so as I, as I mentioned before, we have contacted them for this, and that's what we're actually waiting for. So, uh, we send it to them or we send that request electronically, um.
[AGENT][NEUTRAL] And that's, that's that we see they can't, I can't really verify it over the phone. They have to actually send us a spreadsheet.
[CUSTOMER][NEUTRAL] I mean if they I.
[CUSTOMER][NEUTRAL] OK, well, how long does it typically take to hear back from them?
[AGENT][NEUTRAL] Uh, gosh, you know, normally it just because it's electronic, uh, usually we get it pretty quickly, um.
[AGENT][NEUTRAL] It just depends on when they when they send it to us. It's normally we will just get it, uh, we, um, update the computer and then everything's fine. It doesn't really take that long, um, but if we don't get it and we have to, uh, request it for them, I really don't know how long that would take.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] Yeah, I mean, it's just all on me to make all these phone calls and try to contact these people and get them to do what they should have already done and you know, meanwhile, they're making a bill for me back.
[CUSTOMER][NEGATIVE] Because I couldn't pay. My insurance wasn't active.
[CUSTOMER][NEUTRAL] you know, as far as I can tell.
[CUSTOMER][NEUTRAL] I mean, it's not your fault. I'm sorry, I don't mean to be taking it out on you. I'm just saying it's, it's, it's this employer.
[AGENT][NEUTRAL] No, I, I understand. I, I.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] You know, and I, I will, I guess when I get off the phone, I'll, I'll call them.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yes, sir, if you would do that for us, please, and, and we're just um we're just looking for that verification and, and once they send it to us, we, we should be fine. And then we can go ahead and update our systems.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh insurance benefit verification?
[AGENT][NEUTRAL] Yes, sir. It's a verification uh that they send to us each week.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Well, I'll try to call him and get the ball rolling.
[AGENT][POSITIVE] OK. Well, um thank you and, and we'll be on the lookout for that so that we can get this taken care of.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK, well, will that be something that I have to call the doctor office back again or when you get that verification, I don't know if you know my visit will show up on your end.
[AGENT][NEUTRAL] Uh, it probably won't show up until they, until they actually submit it, and that, um, that just depends on when they, when they submit it to us.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, I don't even know if they were able to submit it, I mean.
[CUSTOMER][NEGATIVE] You know, like it's just an error. I don't see how they could even submit it.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Anyway, I'll probably have to call them too.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Yes, sir. It's possible that you would just just uh once, once you've called your employer and we've, and we've gotten this, um, we've gotten this uh updated.
[CUSTOMER][NEUTRAL] OK. All right, well, I'll reach out to them.
[AGENT][POSITIVE] OK, sir, is, is, if there's nothing else then uh thank you very much for contacting us. I hope you have a very good day, sir. Thanks for contacting A.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But