AccountId: 011433970860
ContactId: ae1f110f-ed1b-47f6-9900-0b05dfaa7ec1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 322720 ms
Total Talk Time (AGENT): 149104 ms
Total Talk Time (CUSTOMER): 97309 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/ae1f110f-ed1b-47f6-9900-0b05dfaa7ec1_20250530T17:54_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'd like to verify an eligibility or effective date on a patient, please.
[AGENT][NEUTRAL] OK, [PII], you're just needing to get, uh, uh, excuse me, eligibility. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Initial of the last name is [PII] if you need that.
[AGENT][POSITIVE] Thank
[AGENT][NEUTRAL] OK, thank you. And the first initial to my last name is [PII]. And what is the member's policy? You're welcome. What is the member's policy number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Policy number is 0236915ML8.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Oh, I think I missed a number. Well, hold on, I did. Hold on one second. Give me that number one more time, please, [PII].
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] 02363915 ML 8
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And any information that I do provide will be a verification of benefits and not a guarantee of payment. What is the patient's name, [PII], and their date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And again, any information provided with the verification of benefits and not a guarantee of payment. So I do show that he is a dependent on this policy.
[AGENT][NEUTRAL] And this supplemental policy is active with an effective date on it of [PII].
[CUSTOMER][NEUTRAL] OK, and the dependent, he's a dependent of [PII], is that correct?
[AGENT][NEUTRAL] Yes, and [PII]'s last name, what did you have it as again?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] His last name is only the [PII] part, but the dad's name they have is the [PII]
[AGENT][NEUTRAL] Yes, it
[AGENT][NEUTRAL] No, um,
[AGENT][NEUTRAL] We only have, we have, we only have the last name as [PII] for both.
[CUSTOMER][NEUTRAL] It's a tongue roll.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. I'm gonna document that in here right now.
[AGENT][NEUTRAL] And then because this is a supplemental policy to the primary insurance, [PII], when the claim is submitted to us for review, we will have to have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And then once the claim has been processed, yeah, well, Cigna will not send us that, but I mean whoever's filing the claim with APL will need to provide the primary EOB also.
[CUSTOMER][NEUTRAL] OK, yeah, that will be from Cigna.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And mhm.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal in which you should be able to check claim status.
[AGENT][NEUTRAL] And our portal website is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you repeat that again? Cause I was typing and nothing was typing.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][POSITIVE] It was secured
[AGENT][POSITIVE] Yes, so the website is secured.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] All right, perfect. Got it this time.
[AGENT][NEUTRAL] All right then. Well, is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] Is there um you don't have APL does not provide a call reference number. It's just your name with today's date, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, great. That's it then. Thank you very much for the information and I have a great weekend.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, I hope you have a great weekend too, [PII], and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Uh-huh, bye bye.