AccountId: 011433970860
ContactId: b351b0e5-15fb-4ca1-86cf-c7481fed8857
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272619 ms
Total Talk Time (AGENT): 128985 ms
Total Talk Time (CUSTOMER): 79065 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/b351b0e5-15fb-4ca1-86cf-c7481fed8857_20250214T15:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from the provider's office to check on member's eligibility and please be advised you're on a recorded call.
[AGENT][NEUTRAL] OK, [PII], you're only needing eligibility. You do not need benefit information, is that correct?
[CUSTOMER][POSITIVE] Yes, yes, you're right.
[AGENT][POSITIVE] Thank you. I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] I'm so sorry. Give me the extension number again, please.
[CUSTOMER][NEUTRAL] Sure, it is [PII].
[AGENT][NEUTRAL] Thank you. And your patient's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] Sure, um, it is 0186.
[CUSTOMER][NEUTRAL] 884 8
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, patient's name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is a subscriber on the supplemental policy.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And it is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] Uh, uh, can you please repeat me the effective date one more time?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And if you do file a claim with APL, yes ma'am, if you do file a claim with APL [PII], we will also have to have a copy of her primary insurance company's explanation of benefits as well for review.
[CUSTOMER][POSITIVE] Got it, thank you.
[AGENT][NEUTRAL] And then once we have processed our claim, we have a portal that you should be able to check claim status and have access to our explanation of benefits, and our portal website is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Thank you so much for that information. And uh may I know, uh, you said this is Medicare supplemental plan, right?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] No, I didn't say it was a Medicare supplemental plan. I said this is a supplemental to her pri private primary insurance.
[AGENT][NEUTRAL] This is not a Medicare supplement.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is a medical supplement to her primary insurance.
[CUSTOMER][POSITIVE] OK, got it. Um, thank you so much for that. And uh is there any group number for this number?
[AGENT][NEUTRAL] 16,350
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you please provide me the time limit and the claims billing address?
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim's mailing address is [PII], [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, sir. Thank you so much for that. And can you please spell your name for my documentation?
[AGENT][NEUTRAL] Yes, my name in today's date will be your call reference number and today my name is spelled [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much for your help and have a wonderful day.
[AGENT][POSITIVE] Yes, ma'am. You're welcome. I hope you have a wonderful day too. And if that's all I can help you with, thank you again for calling APO.
[CUSTOMER][POSITIVE] You too take care bye.
[AGENT][NEUTRAL] Alright, [PII], bye bye.