AccountId: 011433970860
ContactId: c92f32ab-be33-496c-a7a2-92bd82f4bdf4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201660 ms
Total Talk Time (AGENT): 106550 ms
Total Talk Time (CUSTOMER): 49888 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/c92f32ab-be33-496c-a7a2-92bd82f4bdf4_20250514T18:06_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling ACL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I am trying to verify eligibility on this plan and I need to see if they will, if you guys pay to the patient or to the provider.
[AGENT][NEUTRAL] OK, [PII], so you're needing to verify benefits or just eligibility and then find out about all claims.
[CUSTOMER][NEUTRAL] Uh, just eligibility. Uh-huh, yes.
[AGENT][POSITIVE] OK, yes, ma'am. I can help you with that. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] My direct line is [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] It is 01905619.
[AGENT][NEUTRAL] OK, thank you. One moment while I get the member's information pulled up please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information that I do provide for you could see 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] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so I do show she is the subscriber on the supplemental policy, and the supplemental policy is active, Christy with an effective date of [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you.
[AGENT][NEUTRAL] Now as far as who the claim, who the benefits would be paid to if we're able to pay on a claim, it's typically to whomever files the claim first.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Unless there's something, you know, the assignment of benefits that states otherwise.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK. Yeah, I think on her card, it says that she has benefit assignment is what it says.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Med link with benefit assignment.
[AGENT][NEUTRAL] So yes, so whomever files the claim, typically that's how the first one to file it would be the one who would be.
[AGENT][NEUTRAL] Paid if benefits were payable. Now, because it also is a supplemental policy.
[CUSTOMER][POSITIVE] OK, that sounds good.
[AGENT][NEUTRAL] We will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review and then once we process the claim here at APL we do have a portal, [PII], that you should be able to check claim status in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the portal website would be located at [PII].
[CUSTOMER][POSITIVE] OK, perfect. [PII], thanks for your help. I appreciate it and I hope you have a good day.
[AGENT][POSITIVE] I hope you do too, [PII] and again if that's all I can help you with, thank you so much for calling ATL.
[CUSTOMER][POSITIVE] Thank you. Bye bye.