AccountId: 011433970860
ContactId: bb358e50-b241-43e5-8237-ebe0da84dcfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 367660 ms
Total Talk Time (AGENT): 77498 ms
Total Talk Time (CUSTOMER): 132003 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/bb358e50-b241-43e5-8237-ebe0da84dcfd_20250227T20:07_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, good afternoon. Uh, this is from provider office, and I'm trying to see if our providers in network with the members plan.
[AGENT][POSITIVE] OK, I can help you. Give me your name again?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] A business.
[CUSTOMER][NEUTRAL] [PII]. Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII], what's the policy number? Thank you for holding.
[CUSTOMER][NEUTRAL] Yes, uh, the policy number is 01891650.
[AGENT][NEUTRAL] 01896150.
[CUSTOMER][NEUTRAL] No, it's, uh, again 0189150.
[AGENT][NEUTRAL] 150.
[AGENT][NEGATIVE] You're cutting in and out.
[CUSTOMER][NEUTRAL] 1650. It's 1.
[AGENT][POSITIVE] 1650. OK, what's a good.
[AGENT][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] name is
[CUSTOMER][NEUTRAL] uh [PII].
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information and did you say you're calling to verify eligibility?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes, uh, and if our provider and group is in network or off network with this members plan.
[AGENT][NEUTRAL] OK. So I'm showing that the policy effective date is [PII].
[AGENT][NEUTRAL] The policy is active at this time and there is not a network affiliated with this policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So there's no network.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK, so.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, no network affiliated with this the providers, uh, there's no provider affiliated with this, uh, with this members plan you are.
[AGENT][NEUTRAL] So this policy is secondary, this policy is secondary to the major medical policy, so we follow the major medical policy.
[CUSTOMER][NEUTRAL] You mean in that way, right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so for the primary uh primary payer if the providers house level with the primary, uh, payers, so the second denied.
[CUSTOMER][NEUTRAL] The claim for out of network uh provider service.
[AGENT][NEUTRAL] Not necessarily
[AGENT][NEUTRAL] Not necessarily.
[CUSTOMER][POSITIVE] OK. All right, thank you so much for that. Uh, may I know the member plan name?
[AGENT][NEUTRAL] It's a Metlink policy.
[CUSTOMER][NEUTRAL] OK that one. could you please spell that?
[AGENT][NEUTRAL] M E D L I N K.
[CUSTOMER][POSITIVE] OK, well, uh, thank you so much for this information. Um, may I get the call number?
[AGENT][NEUTRAL] Anything else?
[AGENT][NEUTRAL] Anything else I can assist with today before I give you the call?
[CUSTOMER][POSITIVE] No, I'm all good here.
[CUSTOMER][POSITIVE] That's all I need to know. Thank you so much for your information.
[AGENT][NEUTRAL] OK, you
[AGENT][NEUTRAL] You'll use my name and today's date is reference for today's call, [PII], first initial of my last name, [PII]. Anything else?
[CUSTOMER][NEUTRAL] Oh yeah. Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much [PII] for this information. Uh, you have a great day and bye for now.
[AGENT][POSITIVE] You, you're welcome. Thanks for calling APL. Have a good day.