AccountId: 011433970860
ContactId: b94a8515-f676-4934-8b41-7f7e0ce32e7f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257899 ms
Total Talk Time (AGENT): 95592 ms
Total Talk Time (CUSTOMER): 108291 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/b94a8515-f676-4934-8b41-7f7e0ce32e7f_20250617T20:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling to check patient's eligibility.
[AGENT][NEUTRAL] OK, [PII], I'm happy to check eligibility. What is the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, policy is.
[CUSTOMER][NEUTRAL] 02584655.
[AGENT][NEUTRAL] All right, thank you. And then for documentation, do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, my direct line is [PII].
[AGENT][NEUTRAL] Thank you. And then patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], I think that's how it goes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No worries. And then what's the date of birth for [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. The effective date on the plan, it looks like it's [PII].
[CUSTOMER][NEUTRAL] OK. Um, by any chance did you guys receive a claim from us? Um,
[CUSTOMER][NEUTRAL] Our current data service is [PII].
[AGENT][NEUTRAL] Let me take a look. [PII].
[AGENT][NEUTRAL] No, we don't have any claims on file for [PII].
[CUSTOMER][NEUTRAL] OK. Um, so I can go ahead and submit it. What is the correct, uh, what is the valid, uh, address that we need to use for claims?
[AGENT][NEUTRAL] Let's see here one moment. OK, so for this member's policy, claims are actually going to be addressed to IMA Incorporated.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's at [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. Um
[CUSTOMER][NEUTRAL] Um, the card itself I'm looking at.
[CUSTOMER][NEUTRAL] You mentioned this policy. Are we using the policy number or the medical ID cause there's 2.
[CUSTOMER][NEGATIVE] That information out there is kind of confusing.
[AGENT][NEUTRAL] Yeah, um, we can pull it up with that policy cert number, not the medical ID number.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] One more question, I guess affiliated with the French benefits.
[AGENT][NEUTRAL] With I'm sorry, what was it again? Finch benefits, is that what?
[CUSTOMER][NEUTRAL] Are you guys affiliated, yeah, French French benefits.
[AGENT][NEGATIVE] No, I, we are not.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] The reason why is because we got a rejection back.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] From French benefit group and
[CUSTOMER][NEUTRAL] So we're wondering why it was rejected it.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, I can go ahead and resubmit the claim then it might be just the submission issue.
[AGENT][NEUTRAL] Yeah. OK, not a problem. Anything else?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, no. Do you have a call reference for me?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with today's date. My name again is [PII], which is [PII] and then my last initial is [PII].
[CUSTOMER][POSITIVE] OK. Sounds good. Thank you for your help. Have a great day. Take care.
[AGENT][POSITIVE] You're welcome you too bye bye.
[CUSTOMER][NEUTRAL] OK.