AccountId: 011433970860
ContactId: e9ef52b9-66d0-497a-aff1-310648f3576c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288220 ms
Total Talk Time (AGENT): 127486 ms
Total Talk Time (CUSTOMER): 106697 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/e9ef52b9-66d0-497a-aff1-310648f3576c_20250619T15:21_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII]. Good morning. This is [PII] calling from Monvida Health, and I'm just calling to get um benefits on the patient and eligibility, please.
[AGENT][POSITIVE] All right. Happy to check benefits and eligibility. May I please have the policy number, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, I have AA 7973.
[AGENT][NEUTRAL] 887-973
[CUSTOMER][NEUTRAL] That's A as in apple, A as in apple.
[AGENT][NEUTRAL] Oh, A as in apple, OK.
[AGENT][NEUTRAL] I don't think that's one of our policy numbers. Do you have their name or social? We can check by that.
[CUSTOMER][NEUTRAL] I, yes, uh, the social I have on file is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] And the patient's name is [PII].
[AGENT][NEUTRAL] Lastly, OK, one moment.
[AGENT][NEUTRAL] And then for documentation do you have a good call back number please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then if I could just get [PII]'s date of birth.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date is [PII]. Would you like the policy number?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK. It's gonna be 02319924.
[AGENT][NEUTRAL] And we are the members secondary insurance, so this is gonna cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][POSITIVE] Oh, OK, perfect, OK.
[CUSTOMER][NEUTRAL] And that will that includes any office visits or just um.
[AGENT][NEUTRAL] I can double check. Yeah, let me double check on co-pay for an office visit. Um, let's see one moment.
[CUSTOMER][NEUTRAL] I guess it's copy but yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the patient's plan does have an outpatient benefit. It does not cover any sort of physician office visit fee. It will cover treatment in a physician's office, however.
[CUSTOMER][NEUTRAL] OK, so we still bill just for denial just to make sure.
[AGENT][POSITIVE] Mhm. Yeah, you can absolutely.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and OK, and then is there a group number or
[AGENT][POSITIVE] Yeah, absolutely, let me grab that for you.
[AGENT][NEUTRAL] Group number is 22222, so 5 consecutive number 2s.
[CUSTOMER][NEUTRAL] OK, perfect. So the policy number again, let me just repeat it, 02319924.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And she is the main policy holder.
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK, perfect. OK, thank you so much. Oh just to make sure, um, the billing address and claims is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, it's a different [PII]. Let me give you the [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's [PII], and the zip code is [PII].
[CUSTOMER][POSITIVE] OK perfect and it's still APL correct attention [PII].
[AGENT][POSITIVE] Yes, ma'am. Mhm. Correct.
[CUSTOMER][NEUTRAL] OK, OK, perfect. I'll go ahead and update all this information and um I'll go ahead and submit claims and you guys have like a timely filing because she just provided this information to us and she's been seen since [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Oh yeah, no, there's actually no, there's not a timely.
[CUSTOMER][NEUTRAL] She yeah, she was not aware she had it.
[AGENT][POSITIVE] Oh yeah, no there's no timely filing limit so you're good.
[CUSTOMER][POSITIVE] OK, perfect, thank you very much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too [PII] bye bye.
[AGENT][NEUTRAL] Uh bye bye.