AccountId: 011433970860
ContactId: a8bc47b4-37e3-4c50-8bb4-db3536174bca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 341410 ms
Total Talk Time (AGENT): 151253 ms
Total Talk Time (CUSTOMER): 142376 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/a8bc47b4-37e3-4c50-8bb4-db3536174bca_20250203T15:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling to check benefits and eligibility for patients.
[AGENT][NEUTRAL] OK [PII], I can help you with benefits and eligibility. Can I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, sure, so it's [PII].
[AGENT][POSITIVE] OK, thank you so much. And what is the patient's name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh yeah. Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what is [PII]'s policy number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm that would be 01699768 M as in mama L8.
[AGENT][NEUTRAL] OK let me look his policy up real quick for us.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I do show that this policy number is no longer active. It lapsed on [PII], but let me check to see if he does have an active policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] He does, he does have an active policy let me give you that policy number.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh wait, it's for [PII]. Wait a minute. Let me see if he's on this policy.
[AGENT][NEUTRAL] The second one, yes, he is. His effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then this is just to verify his coverage it's not a guarantee of payment. This is a supplemental insurance policy that's billed secondary to the primary. It helps with the deductible, co-pay and co-insurance. He has an inpatient benefit amount of $3000 per occurrence, I'm sorry, per confinement.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then he has an outpatient benefit amount of $300 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And um can I have the policy ID for the new insurance?
[AGENT][NEUTRAL] Yes, I'm sorry, it's 247.
[CUSTOMER][NEUTRAL] So the average insurance mhm.
[AGENT][NEUTRAL] 3092.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 092 so again that's 2473092 and is there a group ID?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] The group number is.
[CUSTOMER][NEUTRAL] Is there a group ID?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes ma'am, the group number is 23143.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] OK, so again, that's 23143.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK and um is there a group name?
[AGENT][NEUTRAL] Nova Southeastern University.
[CUSTOMER][NEUTRAL] Alright perfect and um are we contracted or in network?
[AGENT][NEUTRAL] He can use it with his it's supplement to his primary so he can use it wherever he can use his primary at.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. All right, copy. And um you said the policy official date is [PII]. And um what's the plan type?
[AGENT][NEUTRAL] It's called Medlink.
[CUSTOMER][NEUTRAL] Medli OK hold on.
[CUSTOMER][NEUTRAL] Time time is me link and um.
[CUSTOMER][NEUTRAL] May I ask where are the claims billed to like the PO box?
[AGENT][NEUTRAL] Yes ma'am, um, you'll send it to APL claims.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] PO Box 248,950.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And then the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so again that's PO [PII] 248,950 [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Alright perfect um is preauthorization required for CPAP supplies?
[AGENT][NEUTRAL] No ma'am, because this is not the medical insurance.
[CUSTOMER][NEUTRAL] OK, all right, copy and um I think I'm all set. Can I have uh just your name and a call reference, please?
[AGENT][NEUTRAL] Yes ma'am, my name is [PII] and you can use my name in today's date for your reference.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] OK. [PII], is that with a [PII] or [PII]?
[AGENT][NEUTRAL] It's
[CUSTOMER][POSITIVE] OK, alright, well thank you so much for your assistance, [PII]. mhm.
[AGENT][NEUTRAL] And Miss, Miss
[AGENT][NEUTRAL] Thank you and um what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Mhm, I'm calling on behalf of Robert Teel Medical LLC.
[AGENT][POSITIVE] Thank you so much. Have a blessed day. Thank you.
[CUSTOMER][POSITIVE] Mhm, yeah, well, thank you. Yeah, you too, sorry, mhm, thank you. Goodbye.