AccountId: 011433970860
ContactId: c8deb258-c942-4038-970d-9ad557b7a1ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 472390 ms
Total Talk Time (AGENT): 151996 ms
Total Talk Time (CUSTOMER): 185227 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/c8deb258-c942-4038-970d-9ad557b7a1ba_20250508T18:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'm calling from Promatica. Um, I was wondering if I could check eligibility for one of our patients.
[AGENT][POSITIVE] Yeah, absolutely, [PII]. Happy to check on eligibility. What is their policy number? Do you have that?
[CUSTOMER][POSITIVE] Great.
[CUSTOMER][NEUTRAL] Uh, let's see, I'm actually reading off of um.
[CUSTOMER][NEUTRAL] It has a Medicaid, so I'm not sure if it's gonna be correct or not. It's D as in dog, [PII].
[AGENT][NEUTRAL] Yeah, that's not gonna be our policy number. Do you see anything on there that says like certificate or anything?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] No, they put in policy number of APLI, but that's just.
[CUSTOMER][NEUTRAL] That's just American public life. That doesn't tell us much. Um.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Can you check my demographics if I give you the date of birth and.
[AGENT][NEUTRAL] We can
[AGENT][NEUTRAL] Yeah we can do by name or social if you don't have anything else um so either way works.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] I should be able to do social. Let me just double check that I can get that for you. Uh, let me just go to the registration and just.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sometimes it doesn't reveal itself, so let's just see.
[CUSTOMER][NEUTRAL] Oh pretty much.
[CUSTOMER][NEUTRAL] I've got it. OK, I've got the social, um, so you just tell me what you need first.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, go ahead with that whenever you're ready.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] And his name is [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, [PII]. Give me just a second. Let's see what comes up here.
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just to confirm, [PII], you were looking for uh medical coverage, correct?
[CUSTOMER][POSITIVE] Correct. Yes, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like [PII] uh did have a plan with us at one time. It was effective from [PII] until [PII].
[AGENT][NEUTRAL] Uh, there's no other active coverage for us under his name.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so the, let me just peek real quick. So this is 726 24. So this would have been active during this state of service. OK. Um.
[AGENT][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] So for I guess I'm gonna have to put the coverage in.
[CUSTOMER][NEUTRAL] Here and build.
[CUSTOMER][NEUTRAL] Uri as secondary Medicaid. Um,
[CUSTOMER][NEUTRAL] Can you give me or send me um something.
[CUSTOMER][NEUTRAL] uh confirming the eligibility, um.
[CUSTOMER][NEUTRAL] And and the information I can't find you guys anywhere in our system so for me to just load the insurance it's been.
[CUSTOMER][NEUTRAL] A little bit of a challenge, um, so I'm just looking for the correct information to load.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] To build this out correctly.
[AGENT][NEUTRAL] OK, let me take a look at their card and see some of these um.
[AGENT][NEGATIVE] Limited benefit plans, the claims actually go not, they, they don't come to us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So yeah, the
[CUSTOMER][NEUTRAL] I don't see a copy of the card anywhere either.
[AGENT][NEUTRAL] So the member's plan does have claim information with a payer ID which is not ours, it's different. The, the claims go to IMA so I don't know if that would be helpful.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What is [PII]? What does that stand for?
[AGENT][NEUTRAL] Um, it doesn't give it to me. Let me see, one second.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Sorry, I asked too many questions.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] IMA is a commercial insurance and employee broker. It stands for IMA Financial Group.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] And the claims go to them.
[AGENT][NEUTRAL] Yeah, and I can give you their claims mailing address and payer ID also.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] Oh, fantastic. OK, whenever you're ready.
[AGENT][NEUTRAL] So claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is in [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. Zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the uh payer ID is
[AGENT][NEUTRAL] 645-56.
[CUSTOMER][NEGATIVE] OK, and that is the stupid question, but.
[CUSTOMER][NEUTRAL] That is the payer ID with American Public Life, is that correct?
[AGENT][NEUTRAL] No, that's the payer ID for IMA.
[CUSTOMER][NEUTRAL] Is that what I'm no.
[CUSTOMER][NEUTRAL] 00, for I am in. OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] All right. um.
[CUSTOMER][NEUTRAL] OK. Is there a reference number for the call today, sir?
[AGENT][NEUTRAL] Mhm, yeah, absolutely, [PII]. So call references my name with my last initial and then today's date. The last initial to my name is [PII], first name [PII], and then today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you so much. I really appreciate it.
[AGENT][POSITIVE] Yeah, my pleasure. I hope you have a good rest of your day, [PII].
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.