AccountId: 011433970860
ContactId: b734fd58-3ffa-4029-bc85-2ea72616794f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288940 ms
Total Talk Time (AGENT): 125320 ms
Total Talk Time (CUSTOMER): 105552 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/b734fd58-3ffa-4029-bc85-2ea72616794f_20250305T21:19_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 provider's office to check patient's medical eligibility. Could you please have?
[AGENT][NEUTRAL] OK, [PII], you're only needing eligibility. You do not need benefit information, is that correct?
[CUSTOMER][POSITIVE] No. Yes, you're right.
[AGENT][POSITIVE] OK, yes ma'am. I can help you with eligibility and [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] My callback number is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] Yes, I do have the member's policy as
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, here is the member's policy I have is 01.
[CUSTOMER][NEUTRAL] 829,100. M as in Mike, L as in Lima, the number 8.
[AGENT][NEUTRAL] OK, thank you, one moment please.
[AGENT][NEUTRAL] And any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. [PII], what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name I have is
[CUSTOMER][NEUTRAL] [PII], the last name [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] OK, so I do show she is the spouse of the subscriber on the supplemental policy, [PII], and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Could you
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Again, it is effective [PII] and it is active.
[AGENT][NEUTRAL] And if you all will be filing a claim for her on this policy, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] The policy is
[CUSTOMER][NEUTRAL] For her, for her spouse?
[CUSTOMER][NEUTRAL] And the policy is effective from [PII]. Now the policy is active.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And is there any group name and the group number for the policy?
[AGENT][NEUTRAL] The group number is 23824.
[AGENT][NEUTRAL] And the group name is Swire, S W I R E Properties Incorporated.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] S W I R E Chowpatty.
[AGENT][NEUTRAL] Uh, the second word is properties, Incorporated.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Third bodies Incorporated.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Got it. Thank you. Thank you so much for that.
[AGENT][NEUTRAL] And once, if, if we process a claim for this member?
[CUSTOMER][NEUTRAL] Can I get your name?
[CUSTOMER][NEUTRAL] No. I just need medical eligibility.
[AGENT][NEUTRAL] We do have a portal, [PII], in which
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am, but I'm going to give you our website for our portal.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Which is secured. [PII]. And if a claim is filed with us, you can use this portal to also check claim status.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK. Thank you very much.
[AGENT][NEUTRAL] And my name again is [PII] and you would use my name along with today's date as your call reference number.
[CUSTOMER][NEUTRAL] Is it T [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] OK, [PII]
[AGENT][NEUTRAL] Instead of [PII], yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] No, [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you. May I get call reference?
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you very much for your help.
[AGENT][POSITIVE] You're very welcome, [PII]. Yes, ma'am, and is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Uh, no, it is enough for me. Thank you very much for your help.
[AGENT][POSITIVE] OK. Well, you're welcome and thank you again for calling [PII]. I hope you have a nice rest of your day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah