AccountId: 011433970860
ContactId: c489eeb8-d14f-4720-bd57-84c87064e5dc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 481239 ms
Total Talk Time (AGENT): 139213 ms
Total Talk Time (CUSTOMER): 196968 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/c489eeb8-d14f-4720-bd57-84c87064e5dc_20250523T18:28_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] I'm sorry, I didn't catch your name.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] What was your name again?
[AGENT][NEUTRAL] So, so, mhm.
[CUSTOMER][NEUTRAL] [PII] OK, I'm sorry, thank you, you were cutting in and out. I couldn't hear what you said. Um, I'm calling for eligibility for a patient and to ask a couple questions besides that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you're calling from which facility for meditations?
[CUSTOMER][NEUTRAL] Nationwide Children's Hospital.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02016156
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] First name is
[CUSTOMER][NEUTRAL] Um, [PII] Last name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And date of birth, I'm sorry, [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, so this particular policy was effective from [PII] and it terminated [PII]. Um, let me check and see if I have a new policy. Bear with me.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, I do have a new policy and he's also listed on this one. Let me know when you're ready for the new policy number.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK, the new policy number is 0217.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] 3599.
[CUSTOMER][NEUTRAL] OK, and that was effective when?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Active at the moment.
[CUSTOMER][NEUTRAL] To current.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK to current.
[CUSTOMER][NEUTRAL] And they, they should have a card for that, is that correct? Because the last one I got.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] was the one that I gave you, um, and they scanned that on [PII].
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Oh yeah, they, they probably have a new one but didn't present a new one. They probably have the old one as well. Um, yeah, they, they should have a new card. We send one back when we um got this new policy.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] For them.
[CUSTOMER][NEUTRAL] OK, so my next question is, does the new policy, is it also the plan name Medlink with benefit assignment?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It is gonna be meddling secondary policy, um.
[CUSTOMER][NEUTRAL] Is that still
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's a secondary OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I wondered about I looked it up. I looked up Medlink with benefit assignment because normally benefit assignment means that it's a reference based plan like the the um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The provider has.
[CUSTOMER][NEUTRAL] For reference based the provider doesn't.
[CUSTOMER][NEUTRAL] Um, balance bill, you know, after the insurance pays, but um.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] When I looked it up, it said that it was a gap insurance, um, and which meant that there should have been a primary insurance is
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] We don't have a primary insurance. The other insurance that we have for him is, uh, Medicaid. No, I'm sorry, Aetna Allied. Is that, is that correct? The primary insurance is Aetna Allied?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Let me check, let me um pull that information, bear with me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, based in our system.
[CUSTOMER][NEUTRAL] It should be IPO.
[AGENT][NEUTRAL] Yeah, all state benefit that's what's coming up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hello.
[AGENT][POSITIVE] It's [PII].
[AGENT][NEUTRAL] You still there?
[CUSTOMER][NEUTRAL] Yes, up here. Mhm, yes.
[AGENT][NEUTRAL] Oh, OK, sorry, I thought I lost you. OK.
[AGENT][NEUTRAL] Do you need any other information?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, was Aetna Allied the, the primary payer was that?
[AGENT][NEUTRAL] No, uh, all state benefits.
[CUSTOMER][NEUTRAL] Allstate benefits. Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Allstate oops.
[CUSTOMER][NEUTRAL] And that's a uh medical coverage?
[AGENT][NEUTRAL] Mhm. That's a major medical plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Based on the employer.
[CUSTOMER][NEUTRAL] Oh, OK, OK, um.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Huh, so we don't have any of his credit cards.
[AGENT][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Wow, um.
[CUSTOMER][NEUTRAL] Hold on let me see.
[CUSTOMER][NEUTRAL] Nope.
[CUSTOMER][NEUTRAL] Who
[CUSTOMER][NEUTRAL] No, all we see is, OK, I wonder.
[CUSTOMER][NEUTRAL] Um, I'm, I'm going to give you the, it's still.
[CUSTOMER][NEUTRAL] I don't wanna try to ask for too much information because I don't know what you can give me but um.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] If I give you the Aetna Allied member ID.
[CUSTOMER][NEUTRAL] Can you tell me if that matches the Allstate?
[AGENT][NEUTRAL] We don't have that information. We, they don't give us the major medical numbers. We just see the name.
[CUSTOMER][NEUTRAL] You OK.
[CUSTOMER][NEUTRAL] Mm, OK. All state benefits, OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] All right, then I, OK, is there a call reference number for this so?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK, great, thank you very much for your help.
[AGENT][POSITIVE] OK. You're welcome, [PII]. You're welcome. Have a good day.
[CUSTOMER][POSITIVE] No, that's it thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You too, bye.