AccountId: 011433970860
ContactId: e4a3b54c-1a03-45c0-b5de-84e56d8922f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188800 ms
Total Talk Time (AGENT): 100375 ms
Total Talk Time (CUSTOMER): 53590 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/e4a3b54c-1a03-45c0-b5de-84e56d8922f7_20250528T15:50_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting APR. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] I'm calling from provider's office to check and eligibility. Could you please help me with that?
[AGENT][NEUTRAL] Yes, ma'am, and eligibility. What is the policy number, please?
[CUSTOMER][NEUTRAL] 2521637
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth please?
[CUSTOMER][NEUTRAL] [PII], the last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. It is a direct line.
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Is there anything else that I can tell you about this gap or secondary insurance?
[CUSTOMER][NEUTRAL] OK, it is supplementary care policy.
[AGENT][NEUTRAL] It is, yes.
[CUSTOMER][NEUTRAL] OK. May I know the group number?
[AGENT][NEUTRAL] The group number for the policy is 165.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] 59
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And that's uh the employer is uh [PII] O T A N K I N.
[AGENT][NEUTRAL] Planet Dodge.
[CUSTOMER][NEUTRAL] OK. OK. The group number is 16559, right? Is there any deductibles?
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Uh, OK, let me check here really quickly, um.
[AGENT][NEUTRAL] For the uh policy that uh there's not a deductible. uh, what we do is we will pick up the deductible, co-payment or co-insurance from their major medical for in and out of hospital benefits.
[AGENT][NEUTRAL] So for outpatient hospital, we'll pick up the deductible, co-payment or co-insurance up to $3000 for inpatient services up to $5500.
[AGENT][NEUTRAL] That's just a verification of the benefits, not a guarantee of payment, but it's not, uh, there's no deductible with this policy we pick up the deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, may I know the pay, OK. May I know the payer ID and claims mailing address?
[AGENT][NEUTRAL] It's, it's 60801.
[CUSTOMER][NEUTRAL] May I know the claim's mailing address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] That's in [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And our zip code is [PII].
[AGENT][NEUTRAL] [PII]. Uh-huh.
[CUSTOMER][NEUTRAL] OK, could you, mm.
[CUSTOMER][NEUTRAL] [PII]. OK, the subscriber is the cardholder or dependent?
[AGENT][NEUTRAL] But she's the, she is the cardholder.
[CUSTOMER][NEUTRAL] OK. Could you please spell your name?
[AGENT][NEUTRAL] It's [PII] and we'll use that today's date as our reference. Is there anything else at all I can help?
[CUSTOMER][NEUTRAL] May I know the initial last name?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, what we'll do is we'll use my name, which is [PII], and today's date is a reference. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] No, the, no, the effective date is [PII].