AccountId: 011433970860
ContactId: b6a45a3e-66a2-4b6c-9dfc-fbd0260ee3a4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347720 ms
Total Talk Time (AGENT): 166174 ms
Total Talk Time (CUSTOMER): 124201 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/b6a45a3e-66a2-4b6c-9dfc-fbd0260ee3a4_20250227T21:28_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Mount Sinai Medical Center. Wanted to verify patients eligibility.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], you're only needing eligibility. You do not need benefits, is that correct?
[CUSTOMER][NEUTRAL] Um, yeah, I don't need benefits, but I wanted to find out if, um, what type of plan this is also.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] Um, 23755.
[AGENT][NEUTRAL] That's a group number.
[CUSTOMER][NEUTRAL] That's what I thought. I was like it's too short. Give me a second.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh da da da da da.
[CUSTOMER][NEUTRAL] Why would I do that? OK, um, so it's 2 excuse me, 024.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 43516.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] That copy. Mhm.
[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 date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do see that she is the sub subscriber on the supplemental policy.
[CUSTOMER][NEUTRAL] Welcome.
[AGENT][NEUTRAL] And this supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Again, this is a supplement to our primary insurance that's designed to help with co-pays, deductibles and co-insurance amounts of coverage services.
[AGENT][NEUTRAL] So when you all file a claim on this policy will also need to receive a copy of her primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then we have our portals that you all can check claim status and once we've processed our claim and the website for our portal is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhmm.
[CUSTOMER][NEUTRAL] If, if I was writing, Lord have [PII].
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Who?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] You said [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, there's no dot in between A and [PII].
[AGENT][NEUTRAL] Yeah, it's a [PII] after [PII] and then a [PII].
[CUSTOMER][POSITIVE] Good to know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Got it, that's why I was like I'm putting too many dots. That's why I was like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, should I say one time, yeah, it happens.
[AGENT][POSITIVE] Uh, it certainly does.
[CUSTOMER][NEUTRAL] So this is the website.
[AGENT][NEUTRAL] Uh, that you can check our claim status once the claim has been processed. It's a self registering.
[CUSTOMER][POSITIVE] Good to know.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Portal. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh yeah. Hold on. I'm doing as fast as I can. It's easy. I'm so sorry.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Oh, you're fine. Hey, when things are easy in this day and time, we get, we do get excited about that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I can't help that one. I was like, oh, show me the way.
[CUSTOMER][NEUTRAL] Question, do I have to put the letters behind the, the ID number?
[AGENT][NEUTRAL] Now, in registering for the portal, is that what you're talking about?
[AGENT][NEUTRAL] You don't actually, you don't enter their policy number.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] When it asks for the patient account number, is that what you're talking about? That's the provider's patient account number. That's the account number you all have and submit on the claim.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh my [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK, we didn't get that far. OK, I got you.
[AGENT][NEUTRAL] I think it's, yeah.
[AGENT][NEUTRAL] And so if we don't have a claim on file for the member, you know, it's, you're not gonna be able, you're not gonna find anything, you know, it's gonna give you a.
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] A good old error message.
[CUSTOMER][NEUTRAL] It makes sense when you said that I was like yeah it makes sense. I just stopped. I got too excited.
[AGENT][NEUTRAL] Yeah, no, that's
[AGENT][NEUTRAL] Yeah, that's the tax ID number and then the patient account number for the provider that you all have. Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] Well, you are certainly very welcome. So is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, that seems to be it.
[AGENT][NEUTRAL] OK, and if you need a reference number Priscilla for our call, you would use my name, which again it's [PII] along with today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, you
[CUSTOMER][POSITIVE] Thank you very much. Have a great one.
[AGENT][POSITIVE] I hope you do too and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye now.
[AGENT][NEUTRAL] Ah, bye-bye.