AccountId: 011433970860
ContactId: d9659e3a-7c28-4220-ba37-c5b536557e73
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426959 ms
Total Talk Time (AGENT): 114082 ms
Total Talk Time (CUSTOMER): 104537 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/d9659e3a-7c28-4220-ba37-c5b536557e73_20241231T16:18_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] Hi, this is [PII] calling from provider's office, checking on the eligibility of the patient.
[AGENT][NEUTRAL] OK, [PII], you do not need benefits. You only need to know if a policy is active or not.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Oh yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Yes, the member's ID is.
[CUSTOMER][NEUTRAL] 01369947
[CUSTOMER][NEUTRAL] M as in [PII] in [PII], and number [PII].
[AGENT][NEUTRAL] Thank you. Any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes. The patient's name is, uh, the first name is [PII] and the last name is.
[CUSTOMER][NEUTRAL] [PII] and the date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What is the last name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, we, we have his last name as something different.
[CUSTOMER][NEUTRAL] One moment. I'll just check once.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Uh, I have the same member's name and the last, and last name. One moment.
[AGENT][NEUTRAL] OK, so I can tell you, I can't, because the name does not match.
[AGENT][NEUTRAL] The subscriber's name I show is the last name you're providing me, but this particular insured does not have the same last name.
[CUSTOMER][NEUTRAL] [PII] It's not a last name for the member.
[AGENT][NEUTRAL] For the member but not for the patient that you're inquiring about.
[AGENT][NEUTRAL] According to our records.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But as per our records, the member and the insured both the same only, right?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] I'm sorry, I didn't understand your question, [PII].
[CUSTOMER][NEUTRAL] Like, uh, the member, I mean, uh, the insured and the subscriber, both are same only, right?
[CUSTOMER][NEUTRAL] The subscriber is different and the patient was different for this?
[AGENT][NEUTRAL] They have different last names.
[CUSTOMER][NEUTRAL] But actually, for this, we already received the payment from the BCS with the same member's name.
[AGENT][NEUTRAL] This policy terminated [PII] and they do not have another policy with this company.
[AGENT][NEUTRAL] Is your date of service prior to [PII] or after [PII]?
[CUSTOMER][NEUTRAL] Actually, the member's date of service is [PII].
[AGENT][NEUTRAL] OK, there is no policy with APL for that data service, but I'm unable to verify the last name. Do you not have a copy of the driver's license?
[CUSTOMER][NEUTRAL] No, I don't have anything. Well, one moment, I'll just check.
[AGENT][NEUTRAL] Yes, ma'am. So we have.
[AGENT][POSITIVE] So there have been no claims received by our company.
[AGENT][NEUTRAL] Since [PII] and again, this policy terminated in [PII] with no other active policy after that.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you, thank you so much.
[AGENT][POSITIVE] You're welcome. And is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][POSITIVE] OK. Thank you. Thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Thank you again for calling APL. I hope you have a very nice day and a happy New Year.
[CUSTOMER][NEUTRAL] And can you please provide me the call reference number for this one?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] And I'm so sorry. I just missed your name. Can you please spell out your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you. Thank you, [PII]. Thank you for assisting me. Have a good day. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am. Yes ma'am. You too. Bye bye.