AccountId: 011433970860
ContactId: faf3196f-b46f-4f60-a13c-7405aa7879d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209619 ms
Total Talk Time (AGENT): 104523 ms
Total Talk Time (CUSTOMER): 78182 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/faf3196f-b46f-4f60-a13c-7405aa7879d9_20250313T14:53_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, hi, hi, my name is [PII]. I'm calling from doctor's office, and I was transferred, uh, in order to obtain an eligibility information for a member. Uh, so we just, I just wanna get general information and, uh, can you be be able to provide me what would be the timely funding limit to submit a claim.
[CUSTOMER][NEUTRAL] For the for a member and the employer group plan the I IMA.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can tell you information about, OK, um, Mr. [PII], I can give you information about APL. I cannot give you information on IMA, OK. Uh, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] For the PPO plan.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Yes, and my callback number is gonna be that is uh [PII].
[AGENT][NEUTRAL] [PII] is the last four digits.
[CUSTOMER][POSITIVE] Yeah, yes, you're correct, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And you're calling from which facility for annotation what's the name of the facility?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that's gonna be this is Healthcare Partners.
[AGENT][NEUTRAL] General healthcare.
[CUSTOMER][NEUTRAL] Uh, Genesis Healthcare Partners.
[AGENT][NEUTRAL] Genesis, OK.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy ID number is 2338486.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Sure member's name is gonna be that [PII], I mean so [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, and you say you need eligibility information, correct?
[CUSTOMER][POSITIVE] Yes, correct, ma'am.
[AGENT][NEUTRAL] OK. We have an effective date of [PII].
[AGENT][NEUTRAL] It is active at the moment. This is a sec um sorry, this is a limited hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK, and what would be the mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And the address on this one to submit.
[CUSTOMER][NEUTRAL] OK, and the time to submit a claim.
[AGENT][NEUTRAL] We don't have family filing limits.
[CUSTOMER][NEUTRAL] You don't have
[CUSTOMER][NEUTRAL] Uh, so you don't have any uh limitation we can submit at any time, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK, and it goes to IMA for repricing before it comes to us. Um, the only thing I have for IMA is the address which is [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, and do you have a group number?
[AGENT][NEUTRAL] Um, yes, let me get that for you. And the group number on this one is 70052.
[CUSTOMER][NEUTRAL] OK, and do you have a fax number where we could submit the claim via fax?
[AGENT][NEUTRAL] No, we don't have a fax number to IMA.
[CUSTOMER][POSITIVE] You don't have a fax number, OK, OK, thank you so much, uh.
[AGENT][NEUTRAL] Mhm. I have a payer ID if you need it.
[CUSTOMER][NEUTRAL] Uh, yeah, payer ID, yeah, go ahead.
[AGENT][NEUTRAL] OK, the payer ID is 64556.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah