AccountId: 011433970860
ContactId: ea3b5f9a-23bf-43d6-8d7a-d8f06352885c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 525419 ms
Total Talk Time (AGENT): 219517 ms
Total Talk Time (CUSTOMER): 262634 ms
Interruptions: 4
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/ea3b5f9a-23bf-43d6-8d7a-d8f06352885c_20250514T15:13_UTC.wav
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[AGENT][POSITIVE] Thanks for calling. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from Connect Hearing in [PII], and I am looking into uh benefits for hearing aids for an individual. I have his policy number here.
[AGENT][NEUTRAL] [PII], can I have a callback number for you?
[CUSTOMER][NEUTRAL] Of course you can [PII].
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] and that is direct.
[AGENT][NEUTRAL] Repeat the last four digits for me if you don't mind.
[CUSTOMER][NEGATIVE] I don't mind, but you're gonna throw me off. I [PII].
[AGENT][NEUTRAL] And can you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] Because I have that policy number, the member that you're calling to verify benefits and eligibility for.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yep, 02584203.
[AGENT][NEUTRAL] [PII], could you verify the patient's name and date of birth, and I'll be able to provide you the information that you're requesting.
[CUSTOMER][NEUTRAL] [PII], [PII] is the first name, last name, [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Mm, I have a completely different year.
[CUSTOMER][NEUTRAL] OK, I'm looking at the driver's license [PII].
[CUSTOMER][NEUTRAL] That's the date of birth.
[AGENT][NEUTRAL] Um, could you verify something else, um, like the mailing address?
[CUSTOMER][POSITIVE] I can. I get [PII]'s right here too, so.
[CUSTOMER][NEUTRAL] That's the word.
[AGENT][NEUTRAL] So let me speak to [PII] because it looks like it may be a typo, however, he have to contact us to get changed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], I'm sorry to bother you, but there's might be a little typo in your insurance here. They want to talk to you for a second, OK?
[CUSTOMER][NEUTRAL] Just to verify who you are.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hey [PII], how are you doing? Could you provide me with the mailing your mailing address?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And what is the email well we don't have an email address on file. Could you verify your um date of birth for me?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You have something else in the system.
[CUSTOMER][NEUTRAL] We're careful.
[AGENT][NEUTRAL] What are the last four digits of your social, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Thank you and this is your.
[AGENT][NEUTRAL] So [PII], it's supposed to be [PII], you said that it's supposed to be [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK then you're great.
[AGENT][NEUTRAL] So once I'm done verifying your benefits, we're gonna, I'm gonna transfer you over to customer service so they can change that for you, OK?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, well they gotta change?
[AGENT][NEGATIVE] The date of birth, the year is not matching what you provided me.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Let me speak to the young lady who called in to verify your benefits so I can give her the benefits and then I'm going to have to get a um let you speak to customer service.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Alright, alright, here you go.
[CUSTOMER][POSITIVE] Thank you [PII] I appreciate it. Alright, are we OK?
[AGENT][NEUTRAL] I'm gonna need once we're done with the verification of the benefits, [PII] will have to speak to customer service for them to update his date of birth.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Because it's incorrect in the system, so you're calling to verify benefits for what place of service, [PII]?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] It's uh Connect Hearing in [PII]. It's a hearing vendor, hearing aid vendor, and I'm not sure if [PII] has any.
[AGENT][NEUTRAL] So you need BME.
[AGENT][NEUTRAL] So he has benefits of $500 per calendar year for DME coverage for doable medical equipment.
[CUSTOMER][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] Is that doable medical equipment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is, yes, um, I can give you a code 5261.
[AGENT][NEUTRAL] Well.
[AGENT][NEUTRAL] No, I don't need that. This is a gap insurance. We just assist with deductible copay and co-insurance to the primary. He has $500 per calendar day, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage. However, the, the visit itself won't be covered, but the treatment received in the office does fall under his outpatient benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. That's, that's fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Correct, OK.
[CUSTOMER][NEUTRAL] Now, as far as as far as that goes, since well how do we, how does he claim that 500, would he self file that?
[AGENT][NEUTRAL] Alright, so
[AGENT][NEUTRAL] No, that means that when you guys submit the, no, that is not how this works. You will have to submit the claim to the primary insurance company. I'm not sure who his primary insurance company is. However, once you receive the ELB, when you receive that ELB from them, you will have to submit that claim here and whatever went towards deductible, co-pay and co-insurance, that's when this policy will step in and make a payment on it.
[CUSTOMER][NEUTRAL] Self bill
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Florida blue it looks like.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. That's all I needed. I appreciate it.
[AGENT][NEUTRAL] Alright, so, um.
[AGENT][NEUTRAL] You're welcome. Now, can I speak with [PII] so that he can be transferred to customer service so that someone can update his date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, do you, OK, I can actually have him do that when he has more time on his own phone and stuff like that, is that OK?
[AGENT][NEUTRAL] Well, actually, it's gonna be a problem when you submit the claim being that the date of birth does not matches.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, OK, hold on for a second, [PII].
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Do you wanna talk to her again because she was gonna have you fix that?
[CUSTOMER][NEUTRAL] Hello, hello.
[AGENT][NEUTRAL] Hold one moment, OK, [PII]?
[AGENT][NEUTRAL] Could you hold for one moment while I transfer you to customer service?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] here.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Fer.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi, Ms. [PII], how are you doing?
[CUSTOMER][POSITIVE] Hi Ms. [PII], I'm good. How are you, sweetie?
[AGENT][NEUTRAL] I'm great, thanks for asking [PII]. I have an insured on the phone. He and a provider called to verify his benefits, but it looks like there's a typo with his date of birth, the year.
[CUSTOMER][NEUTRAL] Alright, what's that policy number, dear, and I'll look at it real quick.
[AGENT][NEUTRAL] It is 258-420-3. That's 258-4203.
[CUSTOMER][POSITIVE] OK, thank you. Give me just a moment, we'll get it pulled up.
[CUSTOMER][NEUTRAL] And then we'll pull up the application 258-420-3.
[CUSTOMER][NEUTRAL] OK, is this for [PII]?
[AGENT][NEUTRAL] [PII], yeah, [PII]. It's supposed to be 1968, but we have 69.
[CUSTOMER][POSITIVE] Great. um
[CUSTOMER][POSITIVE] Well, of course we do, darling, of course we do.
[CUSTOMER][NEUTRAL] So let's take a look, let's see.
[CUSTOMER][NEUTRAL] 02584203
[CUSTOMER][NEUTRAL] I shall see if there's an application we're gonna correct it regardless, but I shall see if there's an application.
[CUSTOMER][NEUTRAL] I do not see one, so it should be what year?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] I think we have 69, but it should be [PII].
[CUSTOMER][NEUTRAL] 68.
[CUSTOMER][NEUTRAL] We do. Uh, what kind of benefit is this?
[AGENT][NEUTRAL] This is Melink.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] OK, give me one moment. Let me correct this somewhere else first because if I don't, C A N U A M I think.
[AGENT][NEUTRAL] Medical.
[CUSTOMER][NEUTRAL] Let's try this. OK, so let's correct it one place first and another one. So [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's his date of birth? OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Alright thank you and we'll get it done over here.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, Ms. She, if you refresh your screen, it should be correct now.
[AGENT][POSITIVE] Thank you, Ms. [PII].
[CUSTOMER][POSITIVE] Anytime, dear. You have a good day.
[AGENT][NEUTRAL] You do the same. Goodbye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Thank you for holding, [PII]. So we they're um they've updated your date of birth to [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day bye bye.
[CUSTOMER][NEUTRAL] No.