AccountId: 011433970860
ContactId: ccf04ad8-5ff7-42d4-b137-28165213964d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270179 ms
Total Talk Time (AGENT): 124050 ms
Total Talk Time (CUSTOMER): 102279 ms
Interruptions: 2
Overall Sentiment: AGENT=1.8, CUSTOMER=2.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/ccf04ad8-5ff7-42d4-b137-28165213964d_20250428T12:35_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hello [PII]. Good morning. My name is [PII] from Aetna Health Insurance, uh, COB department, and please be advised it's called being monitored for quality training purposes, and I just called to verify, uh, the eligibility of a member.
[AGENT][NEUTRAL] OK. And did you say that your name is [PII]?
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, [PII] and you're just needing eligibility. You do not need benefits. Is that correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][POSITIVE] Yes sir, I can help you with that and [PII], what is a good call back number for you please? You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh, it's gonna, it's gonna be [PII]. I'm sorry, [PII].
[CUSTOMER][NEUTRAL] I'm so sorry, let me repeat. [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] I'm so sorry, pardon me.
[AGENT][NEUTRAL] The policy number for the member?
[CUSTOMER][NEUTRAL] Oh thank you. I do apologize. The policy number that I do have here is 02488097 followed by M for Mary, L for Lima, and the number 7.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][POSITIVE] Most welcome, thank you.
[AGENT][POSITIVE] Uh, you're welcome.
[CUSTOMER][NEUTRAL] Creation of benefits.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, [PII], so any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Uh, it's gonna be, uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that Mr. [PII] is a subscriber on the supplemental policy.
[AGENT][NEUTRAL] And this supplemental polic
[CUSTOMER][NEUTRAL] It's only for the supplemental plan.
[AGENT][NEUTRAL] This is a supplemental policy to his primary insurance.
[CUSTOMER][NEUTRAL] Um, you didn't submit, I'm so sorry, just to verify this on a supplemental, uh, policy, no medical.
[AGENT][NEUTRAL] This would be a supplemental medical policy to his primary healthcare insurance. We are not a major medical insurance company.
[CUSTOMER][POSITIVE] Perfect, thank you so much.
[AGENT][POSITIVE] You're welcome and it is active.
[CUSTOMER][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] Sorry, go ahead.
[AGENT][NEUTRAL] The policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And [PII], if there is a way to make a note, if a claim is going to be filed with us for him, we will also have to have a copy of his primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim, we have a portal that you should be able to check his claim status in.
[AGENT][NEUTRAL] And the website for our portal is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much and um.
[CUSTOMER][NEUTRAL] This is not a commercial but is on the supplemental medical policy of the member, right, effective [PII] and just the coordination benefits, uh, if there's a coordination of benefits for the members of the insurance.
[AGENT][NEUTRAL] It would not be a coordination of benefits. It's a supplemental policy. We are not a major medical carrier.
[CUSTOMER][POSITIVE] I understand. Thank you so much for providing me this information, [PII], and do we have a call reference number?
[AGENT][POSITIVE] You're welcome. Can I help you with anything? Yes, you would use my name along with today's date. And can I help you with anything else, [PII]?
[CUSTOMER][POSITIVE] Perfect thank you so.
[CUSTOMER][POSITIVE] And none, uh, thank you so much for, uh, providing me all the information that I needed. You're very helpful, [PII]. Have a great day. Bye for now and please.
[AGENT][POSITIVE] Well, you're very welcome. Yes, sir. I hope you have a nice day as well, [PII] and thank you again for calling APL.