AccountId: 011433970860
ContactId: b5aa4c42-f301-4e29-b375-120c2c3eaa83
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278589 ms
Total Talk Time (AGENT): 108388 ms
Total Talk Time (CUSTOMER): 130653 ms
Interruptions: 3
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/b5aa4c42-f301-4e29-b375-120c2c3eaa83_20250407T19:33_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Uh, [PII], I'm calling from a provider's office just to see if the insurance is in effect on a baby.
[AGENT][POSITIVE] I'd be happy to assist with eligibility. May I have your first name please?
[CUSTOMER][NEUTRAL] My name's [PII] last initial [PII]
[AGENT][POSITIVE] And [PII] if I can get a good callback number for you?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] It is um 02465516.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, now this is a tricky one because I'm showing that the dependent was dropped on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] But the
[AGENT][NEUTRAL] Member has family coverage.
[AGENT][NEUTRAL] So I don't know if it's a situation where she just had the grace period to add her and did not officially add her.
[AGENT][NEUTRAL] So I'm gonna say that she's not covered only because our records have not updated. It's showing that she was dropped on [PII], but I am saying that she does have family coverage because the other dependent is covered, so.
[CUSTOMER][NEUTRAL] But I guess
[AGENT][NEUTRAL] I think this is a a paperwork thing.
[CUSTOMER][NEUTRAL] I got you, so she should be covered, but you don't think they added her.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] She should be, but I'm showing that they dropped her on [PII], so I don't know if she just failed to.
[AGENT][NEUTRAL] You know, I know she's automatically covered when she's born for a certain amount of time, but I don't know what may have happened.
[CUSTOMER][NEUTRAL] Well she was born on [PII]. Um, yeah, I'm confused too because I have on here that she has Cigna Primary.
[CUSTOMER][NEUTRAL] And then there's a card and you're the gap, OK, and then the card scanned in is an Aetna card.
[AGENT][NEUTRAL] Yeah, we're, and we're the gap.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh, so maybe she.
[AGENT][NEUTRAL] That's weird.
[CUSTOMER][NEUTRAL] Yeah, I'm fixing to call him at home, see what I'm.
[AGENT][NEUTRAL] So she must have changed insurances.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] I don't know we're in today, but I don't I'm fixing to call them I guess and try to get in touch with the parent because.
[AGENT][NEUTRAL] Unless she's covered by both of her parents, and they both have different insurances.
[CUSTOMER][NEUTRAL] Well, I've put it in here up under.
[CUSTOMER][NEUTRAL] Cigna under [PII] dad's name and then the Aetna card has [PII]'s name on it too so that's why I'm confused so I guess I'll just call them and but you don't have her added to the APL you had her dropped from the APL on 327.
[AGENT][NEUTRAL] Oh, OK. OK.
[AGENT][NEUTRAL] On, yeah, on 327, but like I said, they have the family coverage, so.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] But OK.
[AGENT][NEGATIVE] It's just confusing.
[CUSTOMER][POSITIVE] Well I'll have them call about that. OK, I'll figure out which one the primary is, and I'll have them call about the secondary. Thank you so much. I appreciate it. I'll try to get in touch with the parents and see if they can shed some light on it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] Well, you know, I guess it could. I take that back now. The mama, the mama could have that number because it's got [PII]'s name on here, but it has an 01 beside it, so maybe the dad's covered under the mama. Now I think that'll do it. Let me call them at home, so what I can figure out.
[AGENT][POSITIVE] OK, well, thank you for calling ATS.
[CUSTOMER][NEUTRAL] But I'll tell them I'll tell them that you know I checked on it and that you have it dropped and if they're supposed to be on it they'll just call.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Call there, I guess, or.
[AGENT][NEUTRAL] Um, yeah, they can call us.
[CUSTOMER][POSITIVE] OK. OK, thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.