AccountId: 011433970860
ContactId: ca0ebc87-bc77-4ad3-b42e-066456f8a97b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 459779 ms
Total Talk Time (AGENT): 152234 ms
Total Talk Time (CUSTOMER): 157650 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/ca0ebc87-bc77-4ad3-b42e-066456f8a97b_20250505T21:11_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII]. I'm calling from United Healthcare Group's coordination of benefits department. The purpose of my call is to verify information for the eligibility of a mutual member and for quality assurance purposes, this call is recorded and monitored.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and the coordination of benefits, and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, uh, it's 018130.
[CUSTOMER][NEUTRAL] 35 M for Mary L for Lima 8 that is a policy number.
[AGENT][NEUTRAL] And that was 01813035?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, and a good contact.
[CUSTOMER][NEUTRAL] The uh alpha prefix is.
[CUSTOMER][NEUTRAL] Do you need the other fix?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEGATIVE] Uh, there is an alpha defects in the uh.
[CUSTOMER][NEUTRAL] In the RAID.
[AGENT][NEUTRAL] OK, you can continue.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, the, the ID number is 01813035 M for Mary L for Lima 8.
[CUSTOMER][NEUTRAL] The contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, uh, [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I'm showing that the policy is no longer active. Um, it was effective from [PII], but there is an active policy, um.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Policy number 254.
[AGENT][NEUTRAL] 9473.
[AGENT][NEUTRAL] It's second to United Healthcare only.
[AGENT][NEUTRAL] And it's been active since.
[CUSTOMER][NEUTRAL] Uh, you
[CUSTOMER][NEUTRAL] You mean Miss [PII], uh, the active policy of the member have as for today is, uh, in United Healthcare.
[AGENT][NEUTRAL] I'm sorry, so United Healthcare is primary. This is a secondary policy here with APL, so we're second to the United Healthcare policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I just want to know uh if [PII] is the original effective date.
[AGENT][NEUTRAL] [PII] is the effective date of the policy number that you gave me, but that policy is no longer active. So the policy number that I just gave you is the active policy.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] For the policy that I, uh, that I that I gave you, uh, the effective date, uh, is already term. There is a termination.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] The policy number that you gave me, 1813035 was effective from [PII].
[CUSTOMER][NEUTRAL] Can, uh, may I have the last date of service that will be considered for payment because sometimes it is the end of the month. It's [PII].
[AGENT][NEUTRAL] No, it, it ended on [PII]. There's no payments or anything that happens after [PII] for that for that policy.
[AGENT][NEUTRAL] But there is an active policy as well.
[CUSTOMER][NEUTRAL] Can I have the uh can I have the OI number?
[AGENT][NEUTRAL] For the active policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, sure. Again, it's 254.
[AGENT][NEUTRAL] 9473.
[CUSTOMER][NEUTRAL] 70.
[CUSTOMER][NEUTRAL] And the effective dates for that, uh, new policy number.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] The current
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, uh, to verify, he is the main, uh Miss [PII] is the main policy holder.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, if, uh, [PII] is the main policy holder.
[AGENT][NEUTRAL] Yes, [PII] is the policyholder.
[CUSTOMER][NEUTRAL] This is true active employment.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Alright, ma'am, can I have the group name?
[AGENT][NEUTRAL] Mhm. Hold on one moment.
[AGENT][NEUTRAL] The group name is A like apple, J like juice, C like cat, Management Services.
[CUSTOMER][NEUTRAL] Can I have the group number?
[AGENT][NEUTRAL] Yes, it's 16319.
[CUSTOMER][NEUTRAL] 163.
[CUSTOMER][NEUTRAL] Ma'am, may I know, aside from the medical policies, is there also a pharmacy coverage like the RX vendor?
[AGENT][NEUTRAL] Um, hold on one moment, let me see.
[AGENT][NEUTRAL] Um, so, no, there's no prescription drug, um, benefits on the secondary policy.
[CUSTOMER][NEUTRAL] OK, no pharmacy.
[CUSTOMER][NEUTRAL] Alright, Miss [PII], I think I got all the information that I need. Can I just have the initial of your last name and call reference number as well?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date and my name is [PII], [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alright, uh, once again, Ms. [PII], thank you so much for assisting me and answering all my questions. I go ahead now and enjoy the rest of your ship. Bye for now. Have a blessed day. Bye bye.
[AGENT][POSITIVE] Thank you, [PII]. You also thanks for calling APL. Bye-bye.