AccountId: 011433970860
ContactId: e93cb48f-a55b-4fdd-b1bb-321072305146
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 495890 ms
Total Talk Time (AGENT): 234317 ms
Total Talk Time (CUSTOMER): 184634 ms
Interruptions: 9
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/e93cb48f-a55b-4fdd-b1bb-321072305146_20250606T13:22_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good morning, [PII]. I'm just here to check the eligibility and benefits for one of our patients. I can give you their member ID if you're ready.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're needing eligibility and benefits for one member, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. I'm calling on behalf of Indiana Exceptional Medical Care. And my best contact number would be [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] It's showing here uh D for Delta 43411892. Now, I'm not sure with the first character because the
[CUSTOMER][NEUTRAL] Uh, member ID or member insurance card that the patient gave us is not really clear. It might be D for Delta or the number 0.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so thank you. Now, [PII], on that, were you trying to reach APL or were you trying to reach 90 degree benefits?
[CUSTOMER][NEUTRAL] Um, I'm not sure. I'm just trying to confirm the benefits for this patient's insurance.
[AGENT][NEUTRAL] OK. So, and the reason that I'm asking that is because that D number is for 90 degree benefits and not American Public Life Insurance. Some of these members do have dual coverage, but there should be also another number on their ID card besides that member ID number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'll check real quick.
[CUSTOMER][NEUTRAL] Just give me a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Do you happen to know that number, [PII]?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is that the number you called?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, it's the one ending in 8606.
[AGENT][NEUTRAL] OK, and is that number on their ID card?
[CUSTOMER][NEUTRAL] Uh, yeah, it is.
[AGENT][NEUTRAL] OK, so there should be a policy certificate. There should be some type of other number besides the member ID.
[CUSTOMER][NEUTRAL] I actually, for.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Uh, they did not really show anything.
[AGENT][NEUTRAL] OK, but if I, OK, so under the, what is the, do you have the full social for your patient?
[CUSTOMER][NEUTRAL] Uh, yeah, I do.
[AGENT][NEUTRAL] OK, and what is that number, please?
[CUSTOMER][NEUTRAL] It should be [PII] under [PII].
[AGENT][NEUTRAL] OK, thank you. One moment to let me see if I can locate.
[AGENT][NEUTRAL] A policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on her ID card also, [PII], does it say APL on the ID card?
[AGENT][NEUTRAL] Anywhere
[CUSTOMER][NEUTRAL] Yeah, it does. Mhm. It does. It's under the company.
[AGENT][NEUTRAL] OK, so there should
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] APL. Yeah, sorry?
[AGENT][NEUTRAL] No, that's OK. So, I did locate a policy for her. The correct policy number that you should have is 0256.
[AGENT][NEUTRAL] 9799.
[CUSTOMER][NEUTRAL] Oh, so that's their member ID, right?
[AGENT][NEUTRAL] That's the policy certificate number.
[CUSTOMER][NEUTRAL] OK. 02569799. Is that their um
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] That's the num
[CUSTOMER][NEUTRAL] Insurance number ID with you guys?
[AGENT][NEUTRAL] Yes, it is. It is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] OK, so I do, and again, any information provided would be a verification of benefits and not a guarantee of payment. So I do show she is the subscriber on this hospital indemnity limited benefit plan and this policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information do you need for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Sorry. Uh, just to confirm, the effective date is [PII], right?
[AGENT][POSITIVE] That is correct. Uh-huh.
[CUSTOMER][NEUTRAL] Thank you, [PII]. Um, I'm looking at the primary care or office visit, but you mentioned earlier that this is a limited indemnity plan or a multi-plan, if I'm correct?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That is, yes, that is correct.
[AGENT][NEUTRAL] And for
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Her outpatient sickness benefit for um an office visit, the max benefit per visit is $75.
[AGENT][NEUTRAL] With a maximum of 5 visits per calendar year per covered person.
[CUSTOMER][POSITIVE] OK. Thank you so much. That's all I needed actually. Um,
[AGENT][NEUTRAL] You, you, OK, and then, uh-huh. I was just gonna give you one additional piece of information, um, once the claim has been received and processed by APO we do have a portal, [PII] that you should be able to check her claim status in.
[CUSTOMER][NEUTRAL] Sorry, go ahead.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] And that website that you would go to for that is located at secured.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Found it. OK. Thank you so much. Uh, and you will
[AGENT][NEUTRAL] OK, what you are.
[CUSTOMER][NEUTRAL] I just need to confirm one last time to make sure that you will be processing the claim with that member ID you just gave me, right? 025669799. OK.
[AGENT][POSITIVE] Good. That is correct. Uh-huh.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just to confirm. OK. Uh, before I let you go, [PII], can I just get a call reference number?
[AGENT][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] Yes, ma'am. You're actually going to use my name along with today's date.
[CUSTOMER][NEUTRAL] Uh what's the, your name is spelled as [PII]? And what's your um
[AGENT][NEUTRAL] [PII], actually, [PII] and the first initial to the last name is [PII].
[CUSTOMER][NEUTRAL] Oh, I.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 0
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] OK. I'm all good. Thank you for all your help, [PII]. You have a good one.
[AGENT][POSITIVE] Absolutely. Well, you're, I hope you have a great day and a nice weekend, [PII], and if that's all I can help you with, thank you again for calling APL.
[CUSTOMER][POSITIVE] Yes, have a great weekend too bye.
[AGENT][POSITIVE] Oh thanks bye bye.