AccountId: 011433970860
ContactId: f068c6a2-28ce-49d6-9c3a-f30f24756b64
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199960 ms
Total Talk Time (AGENT): 74321 ms
Total Talk Time (CUSTOMER): 98743 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/f068c6a2-28ce-49d6-9c3a-f30f24756b64_20250513T14:43_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, how are you? I was calling to check eligibility and benefits for patients.
[AGENT][NEUTRAL] OK. Well, I can help you with both the eligibility and benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah my first name is [PII] and the um phone number would be [PII] and then you would just press 1.
[CUSTOMER][NEUTRAL] And um we're calling from the skin cancer treatment center dermatology office.
[AGENT][NEUTRAL] Alrighty, and thank you for that. And [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yep, and you want so it's a payer ID correct?
[AGENT][NEUTRAL] Uh, Pay ID is for electronic payments. It'll say policy er number it should start with a 01 or 02.
[CUSTOMER][NEUTRAL] Um, yeah, I don't see one on the card that's saying 01 or 02. There's a group number but there and then there's a payer ID, and then it just says on the bottom it says like in hospitals benefit certification number that's like a 02 and and OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, 01 or 02. Uh, that's it.
[CUSTOMER][NEUTRAL] OK, so, so this is for outpatient benefit certification number. The other one is for, I mean they're coming in as a.
[CUSTOMER][NEUTRAL] Office visit for a specialist.
[AGENT][NEUTRAL] The numbers are the same, that ML 7 or 8 at the end is different. I just need the numbers.
[CUSTOMER][NEUTRAL] OK, so the, so the in the inhospital benefit certification number would be the 02568989M as in Mary L as in Larry 7.
[AGENT][NEUTRAL] Thank you. Hold on one moment. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, so, um, last name is um [PII] I'm sorry, [PII], and then the first name is [PII]
[AGENT][NEUTRAL] And the date of birth.
[CUSTOMER][NEUTRAL] And the date of birth is um [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And you said this was for a specialist office visit?
[CUSTOMER][NEUTRAL] Yeah, for dermatology specialist, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so for their secondary policy, because this is their secondary policy, um,
[CUSTOMER][POSITIVE] Correct, yeah.
[AGENT][NEGATIVE] It doesn't have any coverage for the office setting. It's only outpatient facilities, so like the emergency room, urgent care, outpatient surgeries, but there's no coverage for the office setting on this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, that's what I was yeah, that's what it looks like because of what the numbers were that they were given, um, OK, yeah, so it's just for the outpatient or for in hospital is that those are the only ones that it covers.
[AGENT][NEUTRAL] Yes, ma'am. Sometimes they do have the the office um setting added, but this particular policy does not have any of that added.
[CUSTOMER][NEUTRAL] OK, so basically it would just be their primary that would go into into play which is that United Healthcare, correct?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, OK, thank you so much for your time I appreciate it.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] Nope, that's it thank you.
[AGENT][POSITIVE] Alright, thanks for calling API. You're welcome. Bye-bye.
[AGENT][NEUTRAL] Um.