AccountId: 011433970860
ContactId: a5e160b5-4d35-47b4-a502-8fd32287c7d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 773169 ms
Total Talk Time (AGENT): 494022 ms
Total Talk Time (CUSTOMER): 247977 ms
Interruptions: 6
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/a5e160b5-4d35-47b4-a502-8fd32287c7d9_20250417T18:46_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, this is [PII] with the pediatric convenient care. Um, I was just trying to verify um some insurance on a patient.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII]. All right. Are you needing to verify eligibility or eligibility and benefits?
[CUSTOMER][NEUTRAL] Yes ma'am, yes ma'am. I'm just trying to see if it this insurance is eligible.
[AGENT][NEUTRAL] Both
[AGENT][NEUTRAL] OK, so you just wanna verify if it's active?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that, [PII]. And what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] It is D47007173.
[AGENT][NEUTRAL] OK, thank you. Um, [PII], that is not an APL policy number. That is the member ID number for 90 degree benefits. Some of the members that have those policies also have APL. Did you call [PII]?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, I called [PII].
[AGENT][NEUTRAL] OK, so you just, um, you selected the APL option. When you call that phone number, it does, depending on the, um, option that you select as to where you go. So option one on that number would be for IMA. Now I'll be happy to check to see if they also have a policy with APL before I connect you over there and then they end up having to transfer you back or if you know for certain they don't have a policy with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's fine, that's fine. I don't, I'm not, I'm not 100% sure, but we can check that.
[AGENT][NEUTRAL] OK, so what is the last
[CUSTOMER][NEUTRAL] I'm thinking that it's inactive anyways, but I just.
[AGENT][NEUTRAL] OK, so what is the last name of the policy? Oh, let me, [PII], I'm so sorry, but there, there's some of us talking over each other, but there's also a little bit of a lag in the call. I can hear the delay. So I'm so sorry about that. Would you go ahead and say what you were gonna say first?
[CUSTOMER][NEUTRAL] You said
[CUSTOMER][NEUTRAL] Yes ma'am, I was just gonna say I think that the policy is inactive, but if so I just need uh to get verification of that.
[AGENT][NEUTRAL] OK, so what is the subscriber's last name?
[AGENT][NEUTRAL] The primary policy.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] The the patient or the subscriber?
[AGENT][NEUTRAL] The subscriber.
[CUSTOMER][NEUTRAL] OK, it's [PII]
[AGENT][NEUTRAL] OK, thank you. So give me a moment to see if I can locate a policy and you did say the last name is [PII] Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and what state does
[AGENT][NEUTRAL] Does he live in?
[CUSTOMER][NEUTRAL] Uh, he lives in [PII].
[AGENT][NEUTRAL] OK, and I think I have located a policy.
[AGENT][NEUTRAL] Alright, so [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII] and then it's [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] OK, so the policy, I did locate a policy with APL. This is a limited benefit plan.
[AGENT][NEUTRAL] That they have and Beckham is a dependent cover dependent on this policy. The policy number is 257.
[AGENT][NEUTRAL] 1829.
[AGENT][NEUTRAL] And it is active.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] According to our records, as of [PII].
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, um,
[AGENT][NEUTRAL] And we do, we do still have this policy as active at this point.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As of now, it is showing as active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] So that would be the only one that he has um a policy with them?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Now that I would not know. I'll still be happy to connect you to 90 degree benefits to see um if there's any coverage with them. But this policy again, it's a limited benefit plan that he has with APL. Now, if you all end up filing a claim for this member, once it's been processed, [PII], we do have a portal that you should be able to check our claim status in and the website for that is secured.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][POSITIVE] Yeah, that'll be good.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So is there anything else?
[CUSTOMER][NEUTRAL] Secured. [PII].
[AGENT][NEUTRAL] Uh-huh, uh-huh.
[AGENT][POSITIVE] Yes ma'am, you have it.
[CUSTOMER][NEUTRAL] OK, alright, and then I think that was it as long as you could just transfer me to 90 degree benefits just to check that over there and then I'll be good.
[AGENT][NEUTRAL] Uh, yes, sir. I certainly will. And again, if for any reason we get disconnected, call the same number that you did and just select option one.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Well, you're welcome and thank you again for calling APL. I hope you have a wonderful rest of your day.
[CUSTOMER][POSITIVE] You as well. Thank you.
[AGENT][NEUTRAL] You're welcome. So one moment, please.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Thank you for calling 9 if you would like to participate.
[CUSTOMER][POSITIVE] I need great benefits. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Well, hi, [PII]. This is [PII] with APL. How are you today?
[CUSTOMER][POSITIVE] I'm good. How are you?
[AGENT][NEUTRAL] I'm doing fine, thank you. So I have a provider on the line who is wanting to check benefit information on a member and I've already provided her the information regarding what they have with APL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But she gave me a member ID number of D 47007173.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The subscriber is [PII], and she's calling on behalf of the dependent child [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me look at that number.
[AGENT][NEUTRAL] OK, cause as of now, yeah, we're still showing this policy is active with the one they have with APO.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] 700.
[CUSTOMER][NEUTRAL] 717.
[CUSTOMER][NEUTRAL] 7.
[CUSTOMER][NEUTRAL] 173.
[AGENT][NEUTRAL] Mhm. You know, do you need me to repeat it again? Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh uh. What's, uh, what's the patient? What's the patient?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] is a subscriber. Uh-huh. [PII] is a policyholder. [PII] is a dependent child.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the lady's name that I have on the line [PII] is [PII].
[CUSTOMER][NEUTRAL] OK, this
[CUSTOMER][NEUTRAL] OK, this person turned on [PII].
[AGENT][NEUTRAL] OK, now in our system they're still active so I.
[AGENT][NEUTRAL] If they're term in your system, I mean, you would have to tell her that, but we're still showing them as active as of now.
[CUSTOMER][NEUTRAL] OK. But we only do the medical, so I, I, you know, I'm, you know, usually you talk to [PII].
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm. Well, now, yes. So, she, she started out with the D number and I can't tell her that it's not active.
[CUSTOMER][NEUTRAL] OK. Yeah. So.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Because that's not a that's an I need degree benefit number ID number, not their APL so I provided her the information in our system and we do still show this policy is active as of now.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I, I just, you know, I'm helping [PII] out. Um, I'm just, you know, so I'm just kinda learning all this stuff. So, can they still have APL benefits and not have medical, I guess.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Well, I, I don't, yeah, I, mm.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] Yeah, I mean, I think they can. I think they can, but we see I didn't tell her this [PII] but we show this policy is paid to 216, but it still shows as active. It doesn't show his term oh she hung up, so she hung up. uh, so we can't tell them, yes, it's active but only paid to the state. If it's active, that's what we say and if it's, you know, term then obviously we give them a term date.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So when they have policies with you with IMA and APL we always have to transfer over for any information related to the.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] You know, the medical ID number, when they give us that D number, yeah, we can't tell them.
[CUSTOMER][NEUTRAL] Medical.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Anything about that information.
[CUSTOMER][NEUTRAL] OK. OK. Well, maybe she'll call back, um.
[AGENT][NEUTRAL] Yeah, she does have the number and she knows it was option one but um anyway.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, well, I'm, you know, like I said, I'm, I'm just kind of trying to, uh, look, you know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, [PII] and that's it.
[CUSTOMER][NEUTRAL] Learn about this and so.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Because I know they can have, I know they can have you all and not have us. They can have a.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I make playing with y'all, but I, you know, as far as if I really don't wanna say on that cause I don't I'm not sure. I just know some have just.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] APL, some have just 90 degree benefits and some have both.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And then we can't give cross information as far as, like you all, we don't give our policy numbers or anything and we don't.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] You know, so that's about as much assistance as I can give you.
[CUSTOMER][NEUTRAL] Tell me, uh, [PII],
[CUSTOMER][NEUTRAL] I, I understand. Tell me what's your callback number?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, our main number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the lady that called again, her, uh-huh, her name was [PII]. I do have her phone number if you want to take that down.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] That she gave me. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]. I might just go ahead and just call her and let her know that um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] that this person had termed
[AGENT][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] So, um, I said [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah. And we do show that as the pay to date currently for this policy, but again, because it's still active in our system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I have to just tell her it's active with us.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] That makes sense. OK. [PII]ell, thank you. It was nice. OK, well, it was nice speaking with you, [PII], and I hope you have a good afternoon.
[CUSTOMER][POSITIVE] All right. Yes, ma'am. Very well.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Uh huh and you have a great weekend.
[AGENT][NEUTRAL] Thanks you too. Are y'all open? Oh, hey, speaking of that, are y'all open tomorrow? OK. I haven't been asked that, but I had just.
[CUSTOMER][NEUTRAL] OK. Uh-huh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, ma'am. We'll be, we'll be gone.
[AGENT][NEUTRAL] You will be open or not?
[CUSTOMER][NEUTRAL] Yeah, we'll be, uh, we're, we're off tomorrow.
[AGENT][NEUTRAL] Yeah, you are closed tomorrow. OK, so I am, I'm gonna just send the team's message out letting, um.
[CUSTOMER][NEUTRAL] Yes, and we're closed, yes.
[AGENT][NEUTRAL] So is that is benefits in a card open? Do you know?
[CUSTOMER][NEUTRAL] It is what? Um, I, I have no.
[AGENT][NEUTRAL] Is that OK? OK, I'm just gonna send the team's message out letting them know that IMA will be closed tomorrow.
[AGENT][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Perfect. Well, I hope you have a nice day off and a nice holiday.
[CUSTOMER][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][POSITIVE] You too, [PII]. Thanks for calling.
[AGENT][POSITIVE] All right, thank you so much. Yes, ma'am, and thank you.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Papa.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.