AccountId: 011433970860
ContactId: f04adcfa-145b-46e9-9fdf-86e49490ea6d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 261700 ms
Total Talk Time (AGENT): 116382 ms
Total Talk Time (CUSTOMER): 74318 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/f04adcfa-145b-46e9-9fdf-86e49490ea6d_20250123T20:30_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from doctor's office and checking the member's eligibility.
[AGENT][NEUTRAL] OK, [PII], you're just needing eligibility. You do not need benefits. Is that correct?
[CUSTOMER][POSITIVE] You're right.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII] with my [PII].
[AGENT][POSITIVE] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 02554602
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] A
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Patient's last name Marked it and first name [PII]. Date of birth, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So I do show that she is a subscriber on the supplemental policy, and the supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] Now when a claim is submitted to APL for review on this plan, [PII], we must also have a copy of the primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim.
[CUSTOMER][NEUTRAL] So your
[AGENT][NEUTRAL] You may check claim status in our portal by going to [PII].
[CUSTOMER][NEUTRAL] you know.
[CUSTOMER][NEUTRAL] So you're the secondary right for this number?
[AGENT][POSITIVE] That is correct. That is correct. This is a supplemental policy.
[CUSTOMER][NEUTRAL] Give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And you don't know, right, who is the primary for this number?
[AGENT][NEUTRAL] The primary insurance that we show for, for her employer is United Healthcare.
[CUSTOMER][NEUTRAL] Do you have the primary
[AGENT][NEUTRAL] But I don't have any detailed information you would have to contact the member for that.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm. You don't have the policy ID as well, right?
[AGENT][NEUTRAL] I do not have any of her
[CUSTOMER][NEUTRAL] You don't have the
[AGENT][NEUTRAL] I do not have her policy information for her primary health care insurance. No, sir. You would have to contact the member to get that.
[CUSTOMER][NEUTRAL] OK. Give me a moment.
[CUSTOMER][NEUTRAL] Call the number.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] Spell your name.
[AGENT][NEUTRAL] [PII], first initial S, the last name.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] When so many is the mailing address for claim submission.
[AGENT][NEUTRAL] Just a moment, please.
[AGENT][NEUTRAL] The claim's mailing address is [PII].
[AGENT][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Timeless filing limit.
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][POSITIVE] Thank you have a great day take care.
[AGENT][POSITIVE] OK, you too, and thank you again for calling APR [PII] and that's all.