AccountId: 011433970860
ContactId: edd5e121-ec4b-4981-b65a-69d1bc039a3a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1005940 ms
Total Talk Time (AGENT): 374438 ms
Total Talk Time (CUSTOMER): 331611 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/edd5e121-ec4b-4981-b65a-69d1bc039a3a_20250314T16:15_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. I need to verify eligibility on some children.
[AGENT][NEUTRAL] It's
[AGENT][POSITIVE] It would be my pleasure to help you with that eligibility. May I ask your name?
[CUSTOMER][NEUTRAL] My name is [PII] calling from Pediatric Associates.
[AGENT][POSITIVE] Thank you, [PII], and a callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patients?
[CUSTOMER][NEUTRAL] It's 10,842,250 ML 8.
[AGENT][POSITIVE] Thank you, [PII]. And
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Once my computer catches up to this.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hang on just a sec. You said 10,842,250?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Could it possibly be 018?
[CUSTOMER][NEUTRAL] Mm let me double check to see if uh.
[AGENT][NEUTRAL] What's
[AGENT][NEUTRAL] I'm checking too because it didn't come up under that policy number. What is the last name?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] OK, got you. I got them pulled up.
[AGENT][NEUTRAL] And what is the what are the patients' names and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. It's for, OK, let me double check. Uh.
[CUSTOMER][NEUTRAL] It's for [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Are these um all patients on the same policy?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. You wanna go ahead and give them all to me? The dates of birth and I can help you with that eligibility.
[CUSTOMER][NEUTRAL] Oh, they, they are different children. I'm sorry.
[AGENT][NEUTRAL] OK, got you on different policies. OK, so you're needing [PII].
[CUSTOMER][NEUTRAL] Yeah, yeah. No, because I have another child, but mhm.
[AGENT][NEUTRAL] Different policy, got you. So let me give you the correct policy number. That correct policy number is 01842250.
[AGENT][NEUTRAL] And for [PII], the policy is active.
[AGENT][NEUTRAL] And the effective date is [PII].
[AGENT][NEUTRAL] And [PII], this is a secondary policy to the policyholders' Major Medical. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, yes, uh, it's only for the major medical, no office visits, co-payments.
[AGENT][NEUTRAL] I can check that if it, she has benefits for office visits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now with this policy, she does have benefits for the office visit.
[AGENT][NEUTRAL] As well as benefits for treatments and procedures in office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the policy doesn't have any type of uh uh alpha.
[CUSTOMER][NEUTRAL] Digits, no? It's just uh.
[CUSTOMER][NEUTRAL] Numeric.
[AGENT][NEUTRAL] Yeah, um, that ML 7 or 8 is not required.
[CUSTOMER][POSITIVE] Oh OK, I see. Thank you very much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Do you provide uh uh reference numbers?
[AGENT][NEUTRAL] The reference number is my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] And I am ready for that next patient whenever you are.
[CUSTOMER][NEUTRAL] OK. I
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Thank you. It's 02464420.
[AGENT][NEUTRAL] And what is that patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's for [PII] Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And you're needing the same type of benefits as well for [PII]?
[CUSTOMER][NEUTRAL] Mm, yes, uh, I just need to verify if they're gonna be covering the co-payments on for the office visits.
[AGENT][POSITIVE] No worries.
[AGENT][POSITIVE] I can help you with that.
[AGENT][NEUTRAL] I'm showing that [PII]'s policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] And of course this is a secondary policy.
[AGENT][NEUTRAL] Now, for the office visit, this policy does not cover the visit, but does cover any procedures or treatments in office, but not for the visit co-pay.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Anything else I can help you with today?
[CUSTOMER][NEUTRAL] Ah yeah, I have more children.
[AGENT][NEUTRAL] Oh, OK. And give me just one second, let me notate this policy.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] All right, I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] It's uh 01611564.
[AGENT][NEUTRAL] And what is that patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's for [PII]. Date of birth, [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][NEUTRAL] Skyler's policy is active. Effective date is [PII].
[AGENT][NEUTRAL] And this policy does not cover the offices at copay.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEGATIVE] I don't know why they're giving us this, this policy, it's not gonna be.
[CUSTOMER][NEUTRAL] He said, oh I have secondary.
[AGENT][NEUTRAL] Yeah, they think everything pays for everything, right?
[CUSTOMER][NEUTRAL] Yeah, I know. Yeah, because my husband used to have this policy, but it was only for hospital, more for hospital than anything else.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Yeah, and some of our policies do provide that office visit benefit, so it's always good to call and check.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's true.
[CUSTOMER][NEUTRAL] OK, and next ID number?
[AGENT][POSITIVE] Mhm. I'm ready.
[CUSTOMER][NEUTRAL] It's 01887405.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK. Logan's policy is active, office visit, co-pay not covered.
[CUSTOMER][NEUTRAL] Not covered, OK.
[CUSTOMER][NEUTRAL] OK, it is better to call so that way you don't have paperwork to to be receiving.
[AGENT][NEUTRAL] Right. And some of our some of our policies do cover the offices of co-pay and some don't.
[CUSTOMER][NEUTRAL] Mm, yeah, I know.
[AGENT][NEUTRAL] Yeah, it's always better to call and verify.
[CUSTOMER][NEUTRAL] Yes, OK. Next ID number?
[AGENT][POSITIVE] And I'm ready for the next one.
[CUSTOMER][NEUTRAL] It's 052512982.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, that's not our policy number.
[CUSTOMER][NEUTRAL] It has an MLA, OK.
[AGENT][NEUTRAL] Give it to me again, maybe I misunderstood.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 052512982
[AGENT][NEUTRAL] OK, 0, OK.
[CUSTOMER][NEUTRAL] Mm let me see if I have a copy of the insurance.
[AGENT][NEUTRAL] What's that last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII], the first name.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check on that cause I think I have that policy pulled up.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] The correct policy number is 02512982.
[CUSTOMER][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] So I did.
[CUSTOMER][NEUTRAL] So I had an extra digit, yeah.
[AGENT][NEUTRAL] Yeah, so
[AGENT][NEGATIVE] And this policy actually is no longer active.
[AGENT][NEUTRAL] And it turned out.
[CUSTOMER][NEUTRAL] When was the Terminated?
[AGENT][NEUTRAL] [PII]. And [PII], I did check to see if they had active coverage under another policy number, and they do not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it didn't cover the office visits either?
[AGENT][NEUTRAL] Let me check and see.
[AGENT][NEGATIVE] It did not.
[CUSTOMER][NEUTRAL] No, OK.
[CUSTOMER][NEUTRAL] All right. And next ID number?
[AGENT][NEUTRAL] Just one second.
[AGENT][NEUTRAL] OK, just a quick second.
[AGENT][POSITIVE] All right, I'm ready.
[CUSTOMER][NEUTRAL] It's 02357140.
[AGENT][NEUTRAL] And that name and date of birth?
[CUSTOMER][NEUTRAL] It's for mostly.
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Now this policy is active as the 6123 offices that are not covered.
[CUSTOMER][NEUTRAL] No, OK.
[CUSTOMER][NEUTRAL] OK. Ma I.
[AGENT][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] Next ID number is 01826185.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] And what, what is that patient's name and date of birth? There's like 11 dependents or 10 dependents on this policy. I was like, whoa.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Too many, right?
[AGENT][POSITIVE] I was singing, I was singing bless him.
[CUSTOMER][NEUTRAL] Oh my God.
[AGENT][NEUTRAL] I can't imagine what's the thing.
[CUSTOMER][NEGATIVE] I cannot even handle one.
[AGENT][NEUTRAL] I know, I, I struggle with 1 and 2, so yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh jeez, yeah, they have so many, wow.
[AGENT][NEUTRAL] Um.
[AGENT][NEGATIVE] Yes, it's a lot. That one got me off caught me off guard. I'm sorry, that's not about who came out.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] What's the patient's name?
[CUSTOMER][NEUTRAL] This one is
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That would make my head spin thinking about all those children.
[AGENT][POSITIVE] They must be special people.
[CUSTOMER][NEUTRAL] Oh my gosh, can you imagine just at dinner time. Oh my God, everybody talking and fighting if they fight.
[AGENT][NEUTRAL] You know they do.
[CUSTOMER][NEUTRAL] Oh God, yeah.
[AGENT][NEUTRAL] Yeah, I have to. I was just thinking about the laundry.
[CUSTOMER][NEUTRAL] Oh my God.
[AGENT][POSITIVE] All the clothes you have to wash. I'm sure they, they help. Um, I do have her pulled up. Her policy is active.
[AGENT][NEUTRAL] Effective date [PII], I'm sorry, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And office visit not covered.
[CUSTOMER][NEUTRAL] And I go, OK.
[CUSTOMER][POSITIVE] Thank you. I have another time.
[AGENT][NEUTRAL] On this policy or different policy?
[CUSTOMER][NEUTRAL] But all these children are adults already, so they're not babies anymore.
[AGENT][POSITIVE] Yeah, that's true. That's true. That'll make it easier. Put them to work, right?
[CUSTOMER][NEUTRAL] Oh, yeah, I.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] Let them wash their own clothes.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] One day you cook, the other one, you know, 7 days.
[AGENT][NEUTRAL] It's, oh, hey, you know what?
[AGENT][POSITIVE] That may be pretty smart. It maybe the, you know, the parents, yeah, you did the cooking, you did the cleaning, sweeping vacuuming, you did the, heck yeah, I can see where the benefit of that would be.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Right, right now.
[CUSTOMER][POSITIVE] Yeah, my [PII], so much.
[AGENT][POSITIVE] Oh, that's funny.
[AGENT][NEUTRAL] And this is
[AGENT][POSITIVE] I'm ready for the next policy whenever.
[CUSTOMER][NEUTRAL] OK, yes. It's 01826191.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that name and date of birth?
[CUSTOMER][POSITIVE] [PII].
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And policy is active as of [PII].
[AGENT][NEUTRAL] 19
[AGENT][NEUTRAL] And offices not covered.
[CUSTOMER][NEGATIVE] Not covered. OK.
[CUSTOMER][POSITIVE] Thank you. And the last patient.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Uh yes, it's uh [PII].
[AGENT][NEUTRAL] And that name and date of birth?
[CUSTOMER][NEUTRAL] For [PII]? [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me check on [PII] because this policy termed on 9122, just check to see if they have active coverage and they do not so their policy was active from 9121 to 9122.
[CUSTOMER][NEUTRAL] 9122.
[CUSTOMER][NEUTRAL] In the coverage, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you very much for all your help. [PII]. Have a wonderful day and nice weekend. Enjoy it.
[AGENT][NEUTRAL] Oh, it's kind of pressure.
[AGENT][POSITIVE] Oh [PII], it's been my pleasure to help you with that eligibility and offices and benefits. Thank you for calling APL. I hope you have a great weekend as well.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you. Bye-bye. Same to you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.