AccountId: 011433970860
ContactId: f746e32a-5439-4962-9263-f2318c9fc543
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299109 ms
Total Talk Time (AGENT): 141203 ms
Total Talk Time (CUSTOMER): 86408 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/f746e32a-5439-4962-9263-f2318c9fc543_20250304T19:30_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] OK
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm just looking to verify a member's um eligibility.
[AGENT][NEUTRAL] OK. You only need eligibility. You do not need benefits. Is that correct?
[CUSTOMER][NEUTRAL] Um, is there any way you'd be able to tell me if they need a referral for seeing like a specialist?
[AGENT][POSITIVE] Yes ma'am, I can help you with that and who am I speaking with please?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. I'm calling from Interventional spine Specialists of Florida.
[AGENT][NEUTRAL] OK, [PII], thank you. And your callback number, please?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]. My extension is [PII].
[AGENT][NEUTRAL] OK, thank you. And [PII], what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Um, I have here.
[CUSTOMER][NEUTRAL] So on the card it just says coverage is individual and it shows a group number.
[AGENT][NEUTRAL] OK, there should be some other type of number on the front of the card also.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Only number that's listed on the ID card is in hospital benefits cert number or outpatient benefit cert number.
[AGENT][NEUTRAL] OK, that's what I'm looking for. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. So 127.
[CUSTOMER][NEUTRAL] 292.
[CUSTOMER][NEUTRAL] 3, M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] OK, thank you, [PII]. One moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and [PII], any information 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 date of birth?
[CUSTOMER][NEUTRAL] It is [PII] S. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So she is a subscriber. However, the policy number that you provided for me is an old policy. That policy actually termed as of [PII].
[AGENT][NEUTRAL] And her current active policy number that you should have?
[AGENT][NEUTRAL] It's 231.
[AGENT][NEUTRAL] 2676.
[AGENT][NEUTRAL] And this policy again is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it looks like we don't have her updated card in her chart here.
[AGENT][NEUTRAL] She's actually had
[AGENT][NEUTRAL] She had another policy number after the one you gave me, but before this one that's currently active now. So yes, you, you need to have the number that I just gave you is what is the most valid for her at this time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That is good to know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this policy is a supplemental policy to her primary insurance, so there is no prior authorization required.
[CUSTOMER][POSITIVE] Awesome. Thank you so much for your help.
[AGENT][NEUTRAL] On this plan.
[AGENT][NEUTRAL] And because. You're welcome and just a couple of additional things, [PII], because this is a supplement to her primary insurance. When the claim is filed with APL, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then once we have processed our claim we do have a portal in which you should be able to check claim status and have access to our EOB and that's located at secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, well, I think I got everything that I needed.
[AGENT][NEUTRAL] And is
[AGENT][POSITIVE] OK, well, if that is all then that I can help you with, thank you again for calling APL and I hope you have a great afternoon.
[CUSTOMER][POSITIVE] You too, [PII]. Thank you.
[AGENT][POSITIVE] Yes, and thank you as well. You're welcome.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Mm bye-bye, [PII].