AccountId: 011433970860
ContactId: e036191f-e9d6-4390-9856-2c5b610fe0da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 319679 ms
Total Talk Time (AGENT): 128843 ms
Total Talk Time (CUSTOMER): 140644 ms
Interruptions: 2
Overall Sentiment: AGENT=1.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/e036191f-e9d6-4390-9856-2c5b610fe0da_20250424T16:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help?
[CUSTOMER][NEUTRAL] See, my name is [PII]. I'm calling from the provider's office to check on patient medical eligibility. Could you please help for that?
[AGENT][NEUTRAL] OK, [PII], you're just needing eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that and what is your callback number?
[CUSTOMER][NEUTRAL] Yeah, sure. My good callback number is [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please [PII].
[CUSTOMER][NEUTRAL] Patient's policy number starts with 60801.
[AGENT][NEUTRAL] OK, that's not the that's our electronic payer ID number.
[CUSTOMER][NEUTRAL] Sorry, sorry. Yes. Uh, the patient's policy number starts with uh
[CUSTOMER][NEUTRAL] Certificate number is
[CUSTOMER][NEUTRAL] I have 2 member IDs of this patient.
[CUSTOMER][NEUTRAL] In hospital benefits certification number, outpatient benefit certification number. Which one it is?
[AGENT][NEUTRAL] It's the first part of either one of those numbers prior to the letters ML.
[CUSTOMER][NEUTRAL] Yeah, the policy number starts with 02460379 M as in Mike, L as in Lima 7.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] This is the first one. Yup, yup.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's first name is [PII] and the date of birth is [PII] and the date, sorry, patient's last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So I do show she is the spouse of the subscriber on this supplemental policy, and this policy is active currently with an effective date of [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I do have
[CUSTOMER][NEUTRAL] I do have one more patient's ID, uh, so,
[AGENT][NEUTRAL] OK, so are you needing eligibility for her?
[CUSTOMER][NEUTRAL] This policy is active as spouse, right?
[CUSTOMER][NEUTRAL] Yeah, yeah. Patient is active for spouse, right? Not a patient.
[AGENT][NEUTRAL] I'm sorry, I didn't understand your question.
[CUSTOMER][NEUTRAL] I do have two patient member IDs. So which one it is uh for patient? Could you please provide me?
[AGENT][NEUTRAL] OK, are you needing, OK, so the policy number itself is 02460379.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] That's the policy number.
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima.
[AGENT][NEUTRAL] The policy number is just the first part of the number, 02460379.
[CUSTOMER][NEUTRAL] After 7.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The other part indicates that it's an.
[CUSTOMER][NEUTRAL] Not include ML.
[AGENT][NEUTRAL] The other part indicates if it's an inpatient admission or an outpatient.
[AGENT][NEUTRAL] But the policy number ends in the 9.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Thank you. You said the policy is active. What is the policy effective date?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Pay is still active. There is no termination.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thank you. Could you please spell out your name?
[AGENT][NEUTRAL] And there's like
[AGENT][NEUTRAL] [PII] My name and today's date will be your call reference number and if a claim is going to be filed with us, [PII], for this number, we will also have to have a copy of the primary insurance company's explanation of benefits as well. And then once the claim has been processed by APL, we have a portal that you can check claim status in by going to [PII].
[CUSTOMER][NEUTRAL] Your name is [PII].
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Could you please confirm your name? [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] OK, OK.
[CUSTOMER][NEUTRAL] Thank you so much, [PII]. You said the policy is active, effective from [PII] policy is still active and patient is a dependent, yeah, yeah, the call reference number your name on it and patient is a dependent and the dependent name is [PII].
[AGENT][NEUTRAL] And my name in today's date.
[CUSTOMER][NEUTRAL] Policyholder name is [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Actually, he's the, yeah, thank you so much, [PII] and I call the number you were name or is it last initial.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. Thank you so much for your patience and assistance. Have a great day, [PII]. Take care. Bye-bye.
[AGENT][POSITIVE] You're very welcome, [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, nothing else.
[AGENT][POSITIVE] OK, thank you again then for calling APL and I hope you have a nice day also.
[AGENT][NEUTRAL] Bye-bye.