AccountId: 011433970860
ContactId: c3d1c914-9462-45de-a089-deb436d291bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276149 ms
Total Talk Time (AGENT): 107927 ms
Total Talk Time (CUSTOMER): 113501 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/c3d1c914-9462-45de-a089-deb436d291bf_20250409T17:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from the provider's office to check on members.
[AGENT][NEUTRAL] I'm sorry, it's a little bit difficult to hear you. Uh, you said we were needing to check eligibility?
[CUSTOMER][NEUTRAL] Um, yes, I'm here to check eligibility for a member here and please be advised you on a recorded call.
[AGENT][NEUTRAL] OK, yes, I can check eligibility for you. uh [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure, no problem. It is [PII] with the extension [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02457349 M as in Mike.
[CUSTOMER][NEUTRAL] L Lima 8.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Ah, member's first name is [PII] and the last name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] All right, got it. Thank you so much for that. And is there any examination right?
[AGENT][NEUTRAL] No, it is currently active.
[CUSTOMER][POSITIVE] Alright, got it. Thank you, thank you so much for that and um.
[CUSTOMER][NEUTRAL] Ah, may I know the plan type? Is it HMO, PPO, or Medicare Medicaid plan?
[AGENT][NEUTRAL] No, so it follows uh major medical guidelines. It is very dependent on major medical as long as they're willing to pay this policy can.
[CUSTOMER][NEUTRAL] Uh, OK, um, so.
[CUSTOMER][POSITIVE] OK. Thank you so much for that. Is there any group number for this member?
[AGENT][NEUTRAL] Uh, yes, one moment.
[AGENT][NEUTRAL] That group number is 2 it's 22925.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Uh, I'm sorry, is it, uh, consecutive 2s or only 22?
[AGENT][NEUTRAL] It's 22925.
[CUSTOMER][NEUTRAL] All right, thank you so much for that. And uh can you please provide me with the timely filing limit and the claim's mailing address?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] There is no timely filing limit. Our mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right, ma'am. Thank you so much for that. And the limit please.
[AGENT][NEUTRAL] I'm so sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Yeah, can I get the timely filing limit for this claim?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][POSITIVE] Oh, I'm sorry for that. Thank you so much for that and uh.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Yeah, no, ah, can you please spell your name for my documentation.
[AGENT][NEUTRAL] Sure, it's [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] No, [PII], that's it for today. And is there any call reference number for today's call?
[AGENT][NEUTRAL] Reference number would just be my.
[CUSTOMER][NEUTRAL] Because we are at the end of the call.
[AGENT][NEUTRAL] Yes, it would just be my first name, last initial and today's date, uh, so my last initial is A.
[CUSTOMER][POSITIVE] Alright, got it, got it. Thank you so much for your help and have a wonderful day.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye.
[CUSTOMER][NEUTRAL] OK bye.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.