AccountId: 011433970860
ContactId: b4643f6c-e0ff-4614-b97c-0f5e865af72e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169940 ms
Total Talk Time (AGENT): 71481 ms
Total Talk Time (CUSTOMER): 76011 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/b4643f6c-e0ff-4614-b97c-0f5e865af72e_20250310T18:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK. Excuse me. Good afternoon, [PII]. My name is [PII] calling from the provider's office checking eligibility on a member, please.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on eligibility for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, I have policy number 02337797 for [PII].
[AGENT][POSITIVE] All right, thank you so much one moment.
[AGENT][NEUTRAL] Alright, and then if I could have [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] Sure. It is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. So the member plan is active. The effective date is [PII]. We are the member's secondary insurance, so this would cover deductible, co-pay, and co-insurance. The primary does not.
[CUSTOMER][NEUTRAL] OK, and what is the timely filing from the
[AGENT][NEGATIVE] No, no timely filing limit.
[CUSTOMER][NEUTRAL] 00 wow. Any um uh.
[CUSTOMER][NEUTRAL] See what procedure this is. I, OK, so this is a mammogram so we're OK. So can you give me benefits for a mammogram?
[AGENT][NEUTRAL] Let's see, so it looks like the member's outpatient benefit on the plan is per calendar day and the max is 500.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Had that patient met for me, uh, can you tell?
[AGENT][NEUTRAL] Well, it's a calendar day, so they have that amount per, yeah.
[CUSTOMER][NEUTRAL] Oh, it's calendar day.
[CUSTOMER][NEUTRAL] OK, per calendar day, uh.
[CUSTOMER][NEUTRAL] And um [PII], what is the initial to your last name?
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Are your calls recorded or do you have a tracking or reference number?
[AGENT][NEUTRAL] Call reference would be my name with my last initial and then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And let me see what else do I need to confirm um the claims mailing address please.
[AGENT][NEUTRAL] Uh, claims mailing address would be [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII], [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][POSITIVE] OK, let's see if I I perfect. You have a great day, [PII]. I'll get this claim, um, filed. Thank you.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] You too, [PII]. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.