AccountId: 011433970860
ContactId: c151d803-d22a-40a9-b809-bb2017bcadb0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 321609 ms
Total Talk Time (AGENT): 126763 ms
Total Talk Time (CUSTOMER): 89701 ms
Interruptions: 3
Overall Sentiment: AGENT=1.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/c151d803-d22a-40a9-b809-bb2017bcadb0_20250507T18:04_UTC.wav
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[AGENT][NEUTRAL] Good for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Calling APL this is [PII].
[CUSTOMER][NEUTRAL] Uh, hi [PII]. My name is [PII] calling on behalf of provider's office, checking for members eligibility.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, [PII], you said you're needing eligibility information only, is that correct?
[CUSTOMER][NEUTRAL] OK [PII], you said you're needing eligibility. Yeah, looking for members eligibility and benefits.
[AGENT][NEGATIVE] OK, [PII], for some reason there's a terrible echo on our call and I'm hearing everything that I say.
[CUSTOMER][NEGATIVE] OK, [PII], for some reason there's a terrible echo on our call and I'm hearing everything that I say.
[CUSTOMER][NEUTRAL] Hold on, one second here, ma'am.
[CUSTOMER][NEUTRAL] Yeah, is it fine now?
[AGENT][POSITIVE] That's better, yes.
[AGENT][NEUTRAL] OK, so you have one member that you're needing eligibility information on [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I can help you and what is your callback number?
[CUSTOMER][NEUTRAL] All right. It is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] OK. It is 02555592.
[AGENT][POSITIVE] 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. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] All right. Yeah, member's name is [PII], and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the subscribe excuse me, the subscriber on this limited benefit plan and it is active with an effective date of [PII].
[CUSTOMER][POSITIVE] Mhm. You're welcome.
[CUSTOMER][NEUTRAL] All right. And what is the group number, ma'am?
[AGENT][NEUTRAL] The group number is going to be one moment I'll provide that information.
[AGENT][NEUTRAL] 70062.
[AGENT][NEUTRAL] And Morgan, if a claim is filed for this member on this policy once it has been processed, we do have a portal in which you should be able to check the claim status and the website for that portal is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right. And perfect, ma'am. So, what is the plan type? What type, what type of plan does the member has?
[AGENT][NEUTRAL] Hospital indemnity limited benefit plan. This is not major medical insurance.
[CUSTOMER][NEUTRAL] All right, so I'm looking for the benefits for DMA purchase.
[AGENT][NEUTRAL] Let me see if DME is covered under this policy. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and DME is not covered.
[CUSTOMER][NEUTRAL] OK. You mean the same member does not have a DME benefits and member only has a health benefits coverage?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, OK, alright, and what's the reference number for the call?
[AGENT][NEUTRAL] Uh, the reference number would be my name along with today's date.
[CUSTOMER][NEUTRAL] OK. Yeah. And one more quick last question here. What is the mailing address for claims, please?
[AGENT][NEUTRAL] The mailing address for this member's policy with the claims would go to IMA.
[AGENT][NEUTRAL] The address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And payer ID is 64556.
[CUSTOMER][POSITIVE] All right, [PII]. Thank you so much and I do appreciate your work and have a wonderful day.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Well, you're certainly welcome. Is there anything else that I can help you with, [PII]?
[CUSTOMER][POSITIVE] Yeah, I'm done with it and I appreciate it. Have a wonderful day.
[AGENT][POSITIVE] OK, well, you're, well, thank you. I hope you do too, and thank you again for calling APL if that is all I can help you with today.
[CUSTOMER][POSITIVE] All right. Thanks.
[AGENT][POSITIVE] Um, you're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Yeah bye