AccountId: 011433970860
ContactId: d4cc6ef5-00a5-4d2d-995a-15135603cc2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210380 ms
Total Talk Time (AGENT): 98453 ms
Total Talk Time (CUSTOMER): 90664 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/d4cc6ef5-00a5-4d2d-995a-15135603cc2f_20250129T19:26_UTC.wav
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[CUSTOMER][NEUTRAL] Huh 226.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling to verify benefits eligibility for a patient we have in the ER.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 6
[AGENT][NEUTRAL] I can help you. What's your name?
[CUSTOMER][NEUTRAL] My name is [PII]. Last name initials is [PII].
[AGENT][NEUTRAL] And you said that you're needing eligibility and then emergency room benefit?
[CUSTOMER][NEUTRAL] Uh, yeah.
[AGENT][NEUTRAL] OK, I can get that for you. Um, what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] OK, the outpatient benefit certification number, whatever is 02554588ML8.
[AGENT][NEUTRAL] OK, and then what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], I don't know how to pronounce that, uh, [PII].
[AGENT][POSITIVE] OK, thank you for that.
[AGENT][NEUTRAL] And so the policy effective date is [PII]. Uh, the policy is active at this time.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the maximum outpatient benefit is up to $1500.
[AGENT][NEUTRAL] And that's a per calendar year benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And information provided is verification, not a guarantee of payment, and I don't show any of that benefit used uh for [PII] or [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This year
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That's OK. I struggled with her name too. Um, I'm just gonna ask them for your name and a car reference number.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Mhm you you'll use my name in today's date as reference for today's call [PII].
[CUSTOMER][NEUTRAL] [PII] uh-huh.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] First initial first initial last name is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, thank you very much and just a quick question I was trying to use the, the provider portal I guess online. I'm not sure if you would know anything about this, but when it got to the point where it said patient account number, I typed in the, the policy I gave you and it told me that it had an issue. Is that the way it's done or no?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Were you trying to check benefits?
[CUSTOMER][NEGATIVE] I was just trying to check eligibility. I don't even like I didn't even care about the benefit at the moment.
[AGENT][NEUTRAL] Yeah, so, so eligibility and benefits is not on our online service center, um, but, um, you said it was asking for the patient account number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so that's like whenever a claim is received you can go and check claim status on that site and it's asking for of course the provider tax identification number and then the patient account number that's on your claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK, yeah, that makes sense.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's what that number is.
[CUSTOMER][NEUTRAL] So APO has no way of like verifying online for eligibility?
[AGENT][NEUTRAL] The PA number.
[AGENT][NEUTRAL] It unfortunately right now it's not set up to verify eligibility and benefits online you'll have to call us.
[CUSTOMER][POSITIVE] OK, well, not an issue. Thank you very much.
[AGENT][POSITIVE] All [PII]. Anything else, [PII], I can help out with today?
[CUSTOMER][NEUTRAL] No, that'd be all.
[AGENT][POSITIVE] Alright, thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.