AccountId: 011433970860
ContactId: cc7dc97a-5877-4edb-952c-9b2dd3a08bda
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 336100 ms
Total Talk Time (AGENT): 137186 ms
Total Talk Time (CUSTOMER): 157269 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/cc7dc97a-5877-4edb-952c-9b2dd3a08bda_20250106T19:01_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Like an hour he could
[CUSTOMER][NEUTRAL] Hi, um, I'm calling in regards to a patient. I wanted to check eligibility.
[AGENT][NEUTRAL] OK, so you're just needing to verify if a policy is active, or do you also need benefits?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um, well, I will need to see if it's just active and to see if, um, her co-payment has changed because last year she had a zero copay.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can help you with this, and who am I speaking with?
[CUSTOMER][NEUTRAL] This is [PII] and I'm calling from Iglesias Family Medicine.
[AGENT][NEUTRAL] OK, [PII]. Thank you. And your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Um, is it the ID number?
[AGENT][NEUTRAL] It would be a policy or policy certificate in hospital or outpatient. It doesn't start with a letter.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Well, I only have her card in.
[CUSTOMER][NEUTRAL] It's gonna have a group number?
[AGENT][NEUTRAL] And then it would have a policy certificate, policy.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Member number.
[AGENT][NEUTRAL] It doesn't, maybe, it may say member, but it's not, uh-huh, but it's, it doesn't start with a letter.
[CUSTOMER][NEUTRAL] On the actual insurance card?
[CUSTOMER][NEUTRAL] Uh huh, the only, well, we have a copy of her insurance and it only has a group number and a member number.
[AGENT][NEUTRAL] Does the member number start with a number?
[AGENT][NEUTRAL] Or a latter.
[CUSTOMER][NEUTRAL] Yes, a a number.
[AGENT][NEUTRAL] OK. What is that number?
[CUSTOMER][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] 836,250
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And any information that I provide for you today would be a verification of benefits, Lupe, and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Let me use her computer.
[CUSTOMER][NEUTRAL] Patient's name is gonna be um [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, and I'm sorry, the, the call cut out on the last name. What was the last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK, so for this policy, there is another company that you would have to verify her eligibility with Lupe, that is Webb TPA.
[AGENT][NEUTRAL] And I can give you their phone number and then I can also connect you with one of their representatives but just in case something were to happen with our call, this is the number that you would call.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me go ahead and um take the number as well.
[AGENT][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and if you could please um.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I'll be happy to connect you. Yes, and is there anything else I can help you with before I do?
[CUSTOMER][POSITIVE] Connect my call thank you.
[CUSTOMER][NEUTRAL] Uh, no, that'll be all, thank you, ma'am.
[AGENT][POSITIVE] OK, well, you're very welcome and thank you for calling APL. I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] Uh huh, OK, thank you, thank you.
[AGENT][NEUTRAL] You're welcome. One moment.
[CUSTOMER][NEUTRAL] Welcome to Web TPA, the administrator for the limited benefit health insurance program underwritten by American Public Life Insurance Company. If this is an emergency, please hang up and dial [PII].
[CUSTOMER][NEUTRAL] If you are a member calling about your premium billing or need to make changes to your account such as an address change, add or drop it dependent or wish to modify your coverage in any way, please call American Public Life at [PII]. If you are a physician or hospital calling to verify medical eligibility, please press 1 for information and phone numbers for the beat.
[CUSTOMER][NEUTRAL] Please note, your call may be monitored or recorded for quality assurance. The information provided during this call is only a description of benefits and is not a guarantee of payment. Benefits are based upon eligibility at the time services are rendered and all plan provisions.
[CUSTOMER][NEUTRAL] Thank you for calling customer service. My name is [PII]. May I have the member ID number?
[AGENT][NEUTRAL] Hi [PII]. This is [PII] with APL and the policy number is 1,836,250.
[AGENT][NEUTRAL] I have a provider on the line. Her name is [PII], and she's calling regarding part 2 to get eligibility.
[CUSTOMER][NEUTRAL] OK, I can assist you. uh, give me one moment let me pull up the number.
[AGENT][NEUTRAL] Well, and would you like [PII]'s callback number?
[CUSTOMER][NEUTRAL] Um, can you verify the member's first name, last name, and date of birth first?
[AGENT][NEUTRAL] This is for [PII] [PII].
[CUSTOMER][POSITIVE] Awesome, OK, you can transfer the provider over thank you [PII].
[AGENT][POSITIVE] Perfect. Thank you. Have a nice afternoon.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] OK, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.