AccountId: 011433970860
ContactId: f5cf63b5-c545-4cdd-a78a-2162e810cee3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243759 ms
Total Talk Time (AGENT): 115634 ms
Total Talk Time (CUSTOMER): 77666 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/f5cf63b5-c545-4cdd-a78a-2162e810cee3_20250220T20:12_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] from 24 on Physicians PC.
[AGENT][NEUTRAL] How may I assist you today?
[CUSTOMER][NEUTRAL] Hi, so I was just wondering, um, I was looking up for a patient. I'm doing a claim and a claim was denied, so I was trying to see if they were effective with um this this insurance around the data service.
[AGENT][NEUTRAL] Yeah. OK.
[AGENT][POSITIVE] Sure, I can assist you with eligibility. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Got it. Sure, the direct line is [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] The patient's policy number?
[CUSTOMER][NEUTRAL] 0229.
[CUSTOMER][NEUTRAL] 2666.
[AGENT][NEUTRAL] OK, thank you. And I'm sorry, uh, did you say your name was [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], I'm so sorry. OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let me go ahead and pull this information, one moment.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Alright, did you need a date of birth?
[AGENT][NEUTRAL] One moment, I'm still waiting on the system.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Thank you. All right, we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Get
[CUSTOMER][NEUTRAL] Right there.
[CUSTOMER][NEUTRAL] OK, were they, um, active in [PII] you said?
[AGENT][NEUTRAL] Yes, the, the policy was effective [PII] till today. It's still active. So yes, it was active during that time of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do they have a different um member ID number?
[AGENT][NEUTRAL] No, it's the same member ID.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right thank you so much.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Do you need me to check on a claim or do you have a date of service that you want me to check on?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, do you have another insurance listed for this patient as well?
[AGENT][NEUTRAL] Um, they should have a primary insurance, um, because we're just a secondary.
[AGENT][NEUTRAL] Um, let me see which one it is, one moment.
[AGENT][NEUTRAL] Um, it looks like employee benefits management is the primary.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And do you see the effective date on that?
[AGENT][NEUTRAL] We're not, we don't have um that information um we only have like the beginning of the year, so we don't know if that's the actual.
[AGENT][NEUTRAL] Um, they, that they got the, the policy, yes, I'm sorry, yeah, we don't have that information.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So far that's it. Um, do you have a reference number?
[AGENT][NEUTRAL] We don't have a reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Miss [PII]?
[CUSTOMER][NEUTRAL] Uh, sure, what was the first name?
[AGENT][NEUTRAL] Sure, that's all, that's [PII], last initial [PII].
[CUSTOMER][POSITIVE] OK, alright, thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.