AccountId: 011433970860
ContactId: bd2c065b-f14f-4dfa-901b-8912f9bd1182
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362279 ms
Total Talk Time (AGENT): 133315 ms
Total Talk Time (CUSTOMER): 154819 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/bd2c065b-f14f-4dfa-901b-8912f9bd1182_20250127T19:56_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 on member eligibility.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, [PII], you're just needing to verify eligibility for a member, is that correct?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] That's that's correct.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Callback number will be [PII] with an extension [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please [PII]?
[CUSTOMER][NEUTRAL] I have the policy number for the member as 0157567 M as in Mike, L as in Lima 8.
[AGENT][POSITIVE] Thank you, one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I believe we were missing a number or maybe I just did not hear all of the number. Could you give me the number again?
[CUSTOMER][NEUTRAL] 015
[CUSTOMER][NEUTRAL] 756-7, M as in Mike.
[CUSTOMER][NEUTRAL] I'm so sorry, it's, I'm gonna repeat that it's 0157.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 5678 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Wow.
[AGENT][NEUTRAL] And any information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's full name is [PII] with the date of birth of [PII].
[AGENT][POSITIVE] Thank you. One moment, please.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so she had been a subscriber on this policy, [PII]. This policy has an effective date of [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And a term date of.
[CUSTOMER][POSITIVE] Thank you. And it's
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it has a term date of [PII].
[CUSTOMER][NEUTRAL] Yes please sorry go ahead.
[AGENT][NEUTRAL] And there is no other active policy with APL.
[CUSTOMER][POSITIVE] Thank you so much. And for the confirmation.
[CUSTOMER][NEUTRAL] The effective date is [PII]. I'm sorry, the termination date, [PII] and the term date is [PII], right? That means the member plan is no longer active, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thank you so much for that.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And uh the thing is I do have one more to check for eligibility. Could you please also help me with that number?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And for this number your name on today's date will be the reference number, right?
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thank you so much for that, [PII], and one moment, let me get the next member's details.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK, shall I provide the next member's ID number if you're ready.
[AGENT][NEUTRAL] You can, yes, that will be fine. Go ahead.
[CUSTOMER][NEUTRAL] I have the, I have the ID number as 02279731 M as in Mike, L as in Lima, 8.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But.
[AGENT][NEUTRAL] OK, and your patient's name and date of birth?
[CUSTOMER][NEUTRAL] And my full name is [PII] So Been [PII] and I have a date of birth for the member as uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. So I do show she is the subscriber on the supplemental policy, and the supplemental policy is active, Lenny, with an effective date of [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And there is no down date, right?
[AGENT][NEUTRAL] No time there. And if you will be.
[CUSTOMER][NEUTRAL] Uh, could you just provide it with the members? Yes, please, sorry.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] May I know the group number or group ID for the member plan?
[AGENT][NEUTRAL] The group number is 15434.
[CUSTOMER][POSITIVE] Thank you and that's all. And what you, uh, I'm so so sorry to interrupt you. You're saying something before.
[AGENT][NEUTRAL] Oh no, that's OK. I was going to say if you all are going to be filing a claim on this policy when the claim is submitted to us for review, we must also have a copy of her primary insurance company's explanation of benefits as well. And then once we have processed our claim, we do have our portal that you can check claim status and have access to our EOBs.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And that portal website for us is secured. [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you so much for that, [PII], and that's all for today. Have a great day and stay safe.
[AGENT][NEUTRAL] Mhm. OK. Well, you too, [PII], and that's all I can help you with. Thank you again for calling APL.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] I