AccountId: 011433970860
ContactId: cdaad576-80bd-4389-a3d6-d82b965803b1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 494890 ms
Total Talk Time (AGENT): 229005 ms
Total Talk Time (CUSTOMER): 127561 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/cdaad576-80bd-4389-a3d6-d82b965803b1_20250401T15:22_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Prisma Health billing office. I was trying to get uh eligibility and benefits for a patient that came in to the ER.
[AGENT][NEUTRAL] OK, well I can help you with both the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you, and may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh, it
[CUSTOMER][NEUTRAL] D like David 43722327
[AGENT][NEUTRAL] All right, do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] Your driver's license?
[AGENT][NEUTRAL] No, their um their insurance ID card.
[CUSTOMER][NEUTRAL] Yeah, I have a copy.
[AGENT][NEUTRAL] So that the number is for 90 degree benefits. Um, do you see anywhere on the card that says in hospital or outpatient policy cert number? It should start with a 01 or 02?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mmm this is the only number that's on here um.
[AGENT][NEUTRAL] OK, to the top left corner, do you see APL like A like apple?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Nope, this is the phone number that was on the card uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is it [PII] or [PII]?
[CUSTOMER][NEUTRAL] No, on the card it's [PII].
[AGENT][NEUTRAL] OK, the reason I'm asking.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] The reason I'm asking is because um so it sounds like you've been redirected to us. This is [PII], but if you call that [PII] number, there's a prompt there no matter who it is, it will direct you to APL. That the number that you gave is the policy number for 90 degree benefits, um, which does work with us, but they work with a lot of other insurance companies too.
[CUSTOMER][NEUTRAL] What if they feel they know on time.
[CUSTOMER][NEUTRAL] What is APL?
[AGENT][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] American public life.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you have the member's full social, I can try with the social and the first and last name just to make sure, but it sounds like you were calling 90 Degrees and got redirected to us.
[CUSTOMER][NEUTRAL] OK, yeah I got the social. You ready?
[AGENT][POSITIVE] Mhm I'm ready.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, hold on one.
[CUSTOMER][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] No, she has 2 accounts with us. Hold on, I have the policy numbers for you.
[AGENT][NEUTRAL] And can you verify her date of birth?
[CUSTOMER][NEUTRAL] Uh, yeah, it is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And are you calling in reference to the um medical policy or the accident policy?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] Alright, so that policy number is 215.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2156.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm sorry, 215-212-6, my apologies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So 215-2126.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it is a hospital indemnity policy. Were you looking for particular benefits or is she like in hospital now?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] ER ER she came in through the ER ER visit.
[AGENT][NEUTRAL] Yeah, OK, hold on one moment.
[AGENT][NEUTRAL] I'm just waiting for the benefits to pop here. And again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it's coming up now.
[AGENT][NEUTRAL] For her hospital indemnity benefit or policy, she doesn't have any coverage for the emergency room. Um, it's only hospital admission, confinement, surgery due to accident or sickness, um, outpatient or in the physician's office, and then diagnostic testing.
[CUSTOMER][NEUTRAL] So she still pays for the ER.
[AGENT][NEUTRAL] If this is the only insurance, yes.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] but her but her member ID number that that's so that's different. So what is the other number for the
[AGENT][NEUTRAL] So that's for 90 degree benefits. That's a different company. Um, you may see that on the ID card.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Um, but yeah, that's for 90 degree benefits. APL would just use that 215-212-6 number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So should she have another uh card or something with that on there?
[AGENT][NEUTRAL] Well, let me take a look at the ID card we have.
[AGENT][NEUTRAL] Hold on one second.
[AGENT][NEUTRAL] Yeah, because our car, so she may have a car from the employee, like a car from the employer with all the coverage on it.
[AGENT][NEUTRAL] I don't know if that's what it is on our card, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I mean, the medical ID number is there, but it's under the policy er number.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Like, so on your card, you don't see APL on it?
[CUSTOMER][NEUTRAL] Yeah, she gave me.
[CUSTOMER][NEUTRAL] Mm, it says MAU Workforce Solutions and it gives you a group number, employee ID, the name and it says medical, which is multi-plan, and then it'll show me like vision and pharmacy, um.
[AGENT][NEUTRAL] Oh yeah, that's her employer card. So that's the card from her job that just lists all her benefits that she's elected. She has an actual APL dental card.
[CUSTOMER][NEUTRAL] APA card, OK, cause I'm gonna call back and let her know.
[CUSTOMER][NEUTRAL] Um, as well.
[CUSTOMER][NEUTRAL] You said, you said dental?
[AGENT][NEUTRAL] I'm sorry, dental and medical, it's either one. We only give cards for dental and medical. Sorry, I just said the wrong one. I'm sorry.
[CUSTOMER][NEUTRAL] Oh, OK. I didn't want to make sure.
[CUSTOMER][NEUTRAL] OK, OK, OK, um.
[CUSTOMER][NEUTRAL] I will let her know and we will go from there. You have a reference number you think for me?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date and again that's [PII] initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you, and I appreciate it.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Mm mm, that was it.
[AGENT][POSITIVE] Alright well thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you bye bye.