AccountId: 011433970860
ContactId: bea01217-778e-4dab-a88f-20e772a56634
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314640 ms
Total Talk Time (AGENT): 128781 ms
Total Talk Time (CUSTOMER): 95690 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/bea01217-778e-4dab-a88f-20e772a56634_20250130T19:50_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] Yeah
[CUSTOMER][NEUTRAL] Hi [PII]. Hi, this is uh [PII] calling from provider office signing member LGBT Information. Can you assist?
[AGENT][NEUTRAL] OK. Did you say that your name is [PII]?
[CUSTOMER][POSITIVE] Yeah, you are right.
[AGENT][NEUTRAL] OK, [PII], and you're needing eligibility and benefits. Is that correct?
[CUSTOMER][POSITIVE] Yeah, I want it, yes, yes.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII] and the extension is [PII].
[CUSTOMER][NEUTRAL] the
[AGENT][NEUTRAL] OK, thank you. And [PII], how many members do you have to check eligibility and benefits for?
[CUSTOMER][NEUTRAL] I have only 13.
[AGENT][NEUTRAL] OK. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] The policy number is going to be 02494276.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I'm gonna, uh, they gonna busy today on it.
[AGENT][NEUTRAL] And any information that I provide for you today, [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] What you
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, yeah, the patient name is uh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the date of birth is going to be.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So I do show that he is a subscriber on this limited benefit plan. This hospital indemnity limited benefit plan is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information are you needing on this limited benefit plan?
[CUSTOMER][NEUTRAL] One hour already.
[AGENT][NEUTRAL] Inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Your 2nd or primary.
[AGENT][NEUTRAL] We are not a major medical insurance company. This is not major medical insurance.
[AGENT][NEUTRAL] Again, this is a hospital indemnity, limited benefit plan only.
[CUSTOMER][NEUTRAL] Yeah, limited benefit plan, yes, sir. Secondary or primary, um, I cannot find it.
[AGENT][NEUTRAL] I, I can't answer that for you. We would not have that information. You would need to speak to the member to see if they have other insurance. This would not be primary.
[CUSTOMER][NEUTRAL] OK. So, the effective date of [PII]?
[AGENT][NEUTRAL] [PII]. Correct.
[CUSTOMER][NEUTRAL] Still active, OK.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] 800
[CUSTOMER][NEUTRAL] 2645256.
[AGENT][NEUTRAL] Hello, [PII], are you still there?
[CUSTOMER][NEUTRAL] Timely firing limit.
[AGENT][NEGATIVE] There is no timely filing limit?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mailing address.
[AGENT][NEUTRAL] Claims mailing address is to IMA [PII].
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] And the payer ID is 64556.
[CUSTOMER][NEUTRAL] [PII] is right.
[AGENT][NEUTRAL] Is the [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] What's the pay ID?
[AGENT][NEUTRAL] 64556.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Call reference number?
[AGENT][NEUTRAL] My name and today's date and then once the claim has been processed, yes, let me give you one more piece of information, [PII]. Once the claim has been processed with APL, you may check claim status by going to our portal at [PII].
[CUSTOMER][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] I'm gonna go.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][POSITIVE] Thank you for that. Bye. Have a nice day, Ty.
[AGENT][POSITIVE] OK, well, you're very welcome and yes, and thank you again for calling APL. Have a nice afternoon as well.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Mhm. Bye bye.
[CUSTOMER][NEUTRAL] The first