AccountId: 011433970860
ContactId: fc1ba8e1-8e58-41ad-a996-6111c48038aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245699 ms
Total Talk Time (AGENT): 116989 ms
Total Talk Time (CUSTOMER): 75823 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/fc1ba8e1-8e58-41ad-a996-6111c48038aa_20250606T17:17_UTC.wav
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[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to check eligibility.
[AGENT][NEUTRAL] OK, you're just needing eligibility and not benefits. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII] with Eisenhower Medical Center.
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Uh, direct number [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Uh, it looks like it's 02553725 M as in Mike.
[CUSTOMER][NEUTRAL] L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] It is [PII] and it's um [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And would you be able to tell me if you guys are primary secondary insurance because we do have another insurance on file for her.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes ma'am. Once I get all of the information loaded, I'll be happy to answer those questions for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And again, any information that is provided would be a verification of benefits and not a guarantee of payment. So what is, um, so I do show that she's the spouse of the subscriber on the supplemental policy, we are, we would not be the primary insurance. This policy is a supplemental plan to her primary health care insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if you all do file a claim for her on this policy, when the claim is submitted to us, [PII] for review, we will also have to have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once um the claim has been processed here, we do have a portal in which you should be able.
[AGENT][NEUTRAL] To check our claim status in and our website for that is located at [PII].
[AGENT][NEUTRAL] Dot
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you tell me when the eligibility started or when the the effective date?
[AGENT][NEUTRAL] Again, yes, ma'am. Again, the effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then, uh, do we mail according to what the patient provided to us, um, the mailing address for you guys is [PII] [PII] and [PII] [PII]?
[AGENT][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK, and then the group number she gave us is 151185?
[AGENT][NEUTRAL] One moment, I can verify that.
[AGENT][NEUTRAL] 15185. Is that correct?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes mhm.
[AGENT][POSITIVE] Yes ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Sounds good I will go ahead and um.
[CUSTOMER][NEUTRAL] Uh, send a claim out with the primary's insurance EOB.
[AGENT][NEUTRAL] Oh, OK then. Well, is there anything else that I could help you with at the moment?
[CUSTOMER][POSITIVE] No, that'll be all thank you so much, [PII].
[AGENT][POSITIVE] Oh, you're certainly very welcome. It's my pleasure speaking to you, [PII], and thank you again for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.