AccountId: 011433970860
ContactId: d6546497-b76a-4bf8-943e-cf893f2d3456
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380660 ms
Total Talk Time (AGENT): 108678 ms
Total Talk Time (CUSTOMER): 136479 ms
Interruptions: 2
Overall Sentiment: AGENT=2.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/d6546497-b76a-4bf8-943e-cf893f2d3456_20250527T19:10_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] Hi [PII], good afternoon. My name is [PII] and I'm calling from United Health Group coordination of benefits department, and I'm calling to verify members eligibility for a mutual member so that we can coordinate benefits correctly. For quality assurance, this call may be monitored and recorded.
[AGENT][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] OK, [PII], so you are trying to verify eligibility only, is that correct for a member?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Yes, member's policy number is 00973964.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, now, any information that is provided for you will be verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, yes, um, the name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the policy number again you gave me was 00973764. Is that correct?
[CUSTOMER][NEUTRAL] 00973964.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And again, what is the patient's or the individual's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, um, name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] But this supplemental policy is active.
[AGENT][NEUTRAL] With an effective date of [PII] for her.
[CUSTOMER][NEUTRAL] [PII] and still active.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] And again, this is a supplemental policy.
[CUSTOMER][NEUTRAL] Um, you've mentioned.
[CUSTOMER][NEUTRAL] Yes, yes, you mentioned that this is only a supplemental policy, so you mean this is not a medical policy?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] It is a medical supplemental policy only. We are not a major medical insurance company.
[CUSTOMER][NEUTRAL] Oh, I see, um, but can you, so.
[CUSTOMER][NEUTRAL] Is this policy to an active employment?
[AGENT][NEUTRAL] It is through her husband. She's on her husband's insurance.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] The name of the group is Blue World Management LLC.
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, and may I confirm if [PII] is only a spouse dependent on this policy.
[AGENT][NEUTRAL] Yes, that is what I stated. I verified that she is the spouse and she became active as of [PII] on this policy.
[CUSTOMER][NEUTRAL] I see, uh, but.
[CUSTOMER][NEUTRAL] For her, for the spouse [PII].
[CUSTOMER][NEUTRAL] Uh, do, do they have the same effective date?
[AGENT][NEUTRAL] No, his effective date is [PII].
[CUSTOMER][NEUTRAL] [PII] version, OK.
[CUSTOMER][NEUTRAL] OK, thank you and can you able to provide also the name of the specialty pharmacy vendor?
[AGENT][NEUTRAL] Uh, this policy does not have pharmacy benefits and there's no network with this policy.
[CUSTOMER][NEUTRAL] OK, I see. OK, no worries, thank you so much for that assistance, [PII], um, but can you please provide me a call reference number for documentation purposes?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[CUSTOMER][POSITIVE] OK, alright, thank you so much. Have a great day and bye for now.
[AGENT][POSITIVE] OK. Well, you're very welcome. I hope you, I hope you have a nice day as well and a nice week, uh, [PII], and thank you again for calling APL.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Uh, you're welcome. Bye bye.