AccountId: 011433970860
ContactId: e4a1900a-4c9c-412e-b4e6-217e8d805efd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292100 ms
Total Talk Time (AGENT): 166121 ms
Total Talk Time (CUSTOMER): 76355 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/e4a1900a-4c9c-412e-b4e6-217e8d805efd_20250127T18:07_UTC.wav
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[AGENT][NEUTRAL] Excuse me. Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I am just calling to verify um my patient has active coverage.
[AGENT][NEUTRAL] OK, you're just wanting to verify if a policy is active, is that correct?
[CUSTOMER][POSITIVE] Correct, yes ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Did you say [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] 606-764
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And uh, [PII], 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?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So yes ma'am, I do show that Mr. [PII] is the subscriber on this general policy and this policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And I don't know if you're aware of this, if anyone's ever given you a portal website, [PII], but if you will file a claim with us once we've processed the claim, you should be able to go to our portal to check claim status and also print out the explanation of benefits.
[AGENT][POSITIVE] And our portal website is secured.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, can you give that to me one more time?
[AGENT][POSITIVE] Sure, secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and I would need to um register as a new user?
[AGENT][NEUTRAL] You would just register mhm you would uh-huh with it and you would set up your own uh username and password, yes ma'am.
[CUSTOMER][POSITIVE] Oh wow, OK, great, thank you so much.
[AGENT][POSITIVE] Well, you are certainly very welcome. And then if you um need any assistance with that or if for some reason it will, it won't find a claim uh without having the claim number, obviously please still give us a call and we'd be happy to assist you with that.
[CUSTOMER][POSITIVE] OK appreciate it have a great day.
[AGENT][POSITIVE] All right. Yes, ma'am. You too. Can I help you with anything else today?
[CUSTOMER][NEUTRAL] That is it. Oh,
[AGENT][NEUTRAL] All right, yeah. Yes.
[CUSTOMER][NEUTRAL] Let me ask you this, any way you can give me like I'm trying to register any way you can give me the patient account number?
[AGENT][NEUTRAL] It's whatever you all have.
[CUSTOMER][NEUTRAL] Or is it just the number that I gave you?
[AGENT][NEUTRAL] It's, no, it, that's the policy number for APL, the provider's patient account number for the member.
[AGENT][NEUTRAL] It's what you're gonna use. Mhm. Like in your system. Correct. That's what you all have in your system for the patient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that would show up on the claim.
[AGENT][NEUTRAL] Your your internal.
[CUSTOMER][NEUTRAL] OK, I'm just looking.
[CUSTOMER][NEUTRAL] OK, so I am looking if you wouldn't mind, I just have a, I'm looking at a um a claim for um a patient and it would be where it says either policy number or reference number would that be the number?
[AGENT][NEUTRAL] OK, when you all file a claim, you have to put.
[AGENT][NEUTRAL] OK, and your computer system.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] You all should have patient account numbers for a member, is that correct?
[CUSTOMER][NEUTRAL] OK, well, we use letters.
[AGENT][NEUTRAL] With your, for your.
[AGENT][NEUTRAL] OK, well, whatever your patient account number is.
[AGENT][NEUTRAL] That's how it would be entered.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, I got what you mean now thank you.
[AGENT][NEUTRAL] OK, well you're welcome and if we don't have a claim on file, obviously it's not going to you know pull anything up so the claim would have to be filed first before you can, you know, access anything um in the system, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Well, you are so welcome. And again, thank you for calling APL. I hope you have a very nice afternoon.
[CUSTOMER][NEUTRAL] You too mm bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you