AccountId: 011433970860
ContactId: dbc8c2a0-0d54-429a-bede-a0c1dc2f2e33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 244330 ms
Total Talk Time (AGENT): 104118 ms
Total Talk Time (CUSTOMER): 108548 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/dbc8c2a0-0d54-429a-bede-a0c1dc2f2e33_20250327T15:46_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] Yes, good morning. My name is [PII] Last name [PII] calling from a doctor's office. I want to verify eligibility for a patient, please.
[AGENT][NEUTRAL] I can help you with eligibility. A what Adie, what is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the policy number for the patient?
[CUSTOMER][NEUTRAL] I think is um number 026-06875.
[AGENT][NEUTRAL] Thank you, [PII]. And the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] The name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you, and I can help you with the eligibility. [PII], I am showing the policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, and current. And uh can you verify if the doctor is uh in network with this plan because really, I don't know about this insurance. It's the first time that I see this insurance. Uh, I don't know if uh we are allowed to see this patient. I can give you the doctor's tax ID number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So this policy does participate in a multi-plan network, but it is not required for benefits.
[CUSTOMER][NEUTRAL] So meaning, how can I verify if we can see the patient?
[AGENT][NEUTRAL] As far as.
[AGENT][NEUTRAL] Our processing of the claim, no network participation is required. We pay both in and out of network benefits. Now you can check with multiplan to see if you are a multi plan provider.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But that is strictly through multi plan. It does not affect the processing of claims with APL.
[CUSTOMER][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] OK, so meaning we can see the patient and everything is that the card I don't have the card yet in the back I can find the payer ID number and uh.
[CUSTOMER][NEUTRAL] And uh the, the, the claim mailing address?
[AGENT][NEUTRAL] Yes ma'am, it would be on the back of the card, but I can also provide that to you if you'd like.
[CUSTOMER][NEUTRAL] OK, please.
[AGENT][NEUTRAL] The payer ID is 64556.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 645.
[AGENT][NEUTRAL] Claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Of
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] 21.
[CUSTOMER][POSITIVE] 21. OK, ma'am. Thank you so much for your help. Thank you.
[AGENT][POSITIVE] [PII], it's been a pleasure to assist you with that eligibility and information. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, just one more question. What about for the diagnostic testing?
[CUSTOMER][NEUTRAL] Like an echo cardiogram 93306.
[CUSTOMER][NEUTRAL] OK, uh, do they also
[CUSTOMER][NEUTRAL] Do I need authorization to do those tests?
[AGENT][NEUTRAL] No, ma'am. This is not a major medical policy. It is an indemnity policy. Therefore, authorization or pre-cert is not required.
[CUSTOMER][NEUTRAL] Uh, OK, that's fine.
[CUSTOMER][POSITIVE] Thank you so much. Take care.
[AGENT][POSITIVE] It's been my pleasure to assist you and thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. You too, ma'am. Take care. Bye-bye.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.