AccountId: 011433970860
ContactId: d2c92b93-3d15-4af7-bc16-be41a9f8cc7e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177490 ms
Total Talk Time (AGENT): 86559 ms
Total Talk Time (CUSTOMER): 70852 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/d2c92b93-3d15-4af7-bc16-be41a9f8cc7e_20250312T13:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Lives. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. I need to verify a patient's eligibility and to make sure that we are in network.
[AGENT][NEUTRAL] OK, I can help you with that. Can I get the policy number? Um well, first, I'm sorry, let me get your name and a callback number.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And callback number.
[CUSTOMER][POSITIVE] And a good call back number [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] It is 02555826.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], and then [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying the account and is this for dental or medical?
[CUSTOMER][NEUTRAL] This is medical.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do show that the policy has been effective since [PII]. It is still active and you did ask about um being in network.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so this is a limited medical plan. There is no network, uh, so the patient can go to any provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, so my question is, um, we use Athena and whenever I try to type it in it's not pulling anything up for you guys so I was trying to figure out is there a different way or a different name that you guys use to for other clinics to to find the eligibility.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, no, uh, for eligibility, the only, uh, way to do that would be to go through our portal.
[AGENT][NEUTRAL] Um, if you want to pull up the eligibility, you could create an account, uh, through our portal to see that, uh, but this is because it's a limited medical plan, um, that type of access you would not be able to, um, like pull it up in a system where it shows eligibility other than our own personal portal.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and do you guys, um, do you guys have a payer ID number or EDI number?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, the payer ID for this policy is 64556.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK all right I really appreciate it.
[AGENT][NEUTRAL] You're welcome, [PII]. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No ma'am, that'll be it.
[AGENT][POSITIVE] OK, you have a wonderful day. Thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye bye.