AccountId: 011433970860
ContactId: f7f55f3c-65ea-422a-8578-6ced6685e251
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309239 ms
Total Talk Time (AGENT): 156486 ms
Total Talk Time (CUSTOMER): 116618 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/f7f55f3c-65ea-422a-8578-6ced6685e251_20250217T20:21_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good afternoon.
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Northside Hospital, the [PII] location.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is my line breaking up as bad as yours is?
[AGENT][NEUTRAL] Not at the moment, but I've had other people that were having they were having phone issues and I wasn't having phone issues. I can hear you OK.
[CUSTOMER][NEUTRAL] They were
[CUSTOMER][NEUTRAL] OK, because I'm only catching like every other word.
[AGENT][NEUTRAL] Do you want to just try and call back?
[CUSTOMER][POSITIVE] No, I could hear that whole sentence. Maybe it's getting better.
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Northside Hospital. I would need to verify coverage for a patient please and get timely filing.
[AGENT][NEUTRAL] OK, [PII], so you, you, you need eligibility and benefit information, is that correct?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, I can help you with those things. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] [PII] and that's direct.
[AGENT][POSITIVE] Thank you and the member's policy number please.
[CUSTOMER][NEUTRAL] 02455103.
[AGENT][NEUTRAL] OK, thank you, [PII]. One moment, please.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And any information that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient benefit
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] Hello, yeah, I, I, I didn't catch anything. All I heard was this is not and then it went blank.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so any information that I provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now are you needing is this for a future data service? What is your data service that you're needing eligibility for?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so, OK, she was the subscriber on this policy and it was active from [PII].
[CUSTOMER][NEUTRAL] It was
[AGENT][NEUTRAL] To its termination date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So she was active and what is timely filing?
[AGENT][NEUTRAL] There is no timely filing limit with APL now because this was a supplemental policy to her primary health care insurance, when you do submit the claim to APL, we must also have receive a copy of her primary insurance company's explanation of benefits along with the claim as well.
[CUSTOMER][NEUTRAL] policy
[CUSTOMER][NEUTRAL] As a primary
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we have processed our claimed IM we do have a portal that you should be able to check our claim status and have access to our EOBN by going to secured.
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Do
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The mailing address please to make sure I have it correct.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] And is there a payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Um, I think I missed something 0801.
[AGENT][NEUTRAL] The first digit is 6.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] 60.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Perfection, thank you so much and lastly the most important thing, what was your name? I apologize when I got on.
[AGENT][NEUTRAL] My name is [PII] and you will use my name and today's state as your call reference number if you need one, [PII].
[CUSTOMER][NEUTRAL] My name is [PII]
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your time I hope you have a good rest of your day oh no I didn't get timely filing that's right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, no, uh.
[AGENT][NEGATIVE] Yes you, yes ma'am, no timely filing there's no timely filing limit.
[CUSTOMER][NEUTRAL] No time as long as the primary EOB is provided, OK.
[AGENT][NEUTRAL] Yes, we do have to have that to review a claim. OK, I hope you do too and thank you again for calling APL.
[CUSTOMER][POSITIVE] All right, thank you so much you have a good rest of your day.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.