AccountId: 011433970860
ContactId: fd40b729-0d51-4208-8839-3b4cff979555
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192910 ms
Total Talk Time (AGENT): 94000 ms
Total Talk Time (CUSTOMER): 68287 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/fd40b729-0d51-4208-8839-3b4cff979555_20250218T13:42_UTC.wav
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[AGENT][NEGATIVE] APL this is Shy line.
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from Bayview Physician Services regarding eligibility and benefits.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and the policy number?
[CUSTOMER][NEUTRAL] Direct line is [PII].
[CUSTOMER][NEUTRAL] And the ID is
[AGENT][NEUTRAL] And then, what is
[CUSTOMER][NEUTRAL] My name is [PII]. Last initial is [PII]
[AGENT][NEUTRAL] No, I was about to ask you what was the policy number? I heard you when you gave me your name. Thank you.
[CUSTOMER][NEUTRAL] OK, 02553123.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth that you're inquiring eligibility for, [PII]?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for what place of service for [PII]?
[CUSTOMER][NEUTRAL] Uh, she was in the hospital. That place of service is.
[AGENT][NEUTRAL] Inpatient.
[CUSTOMER][NEUTRAL] 21.
[AGENT][NEUTRAL] So she has inpatient benefits of $1000 per occurrence, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage. And her policy has been active since [PII] and is currently active and she has not utilized any of her benefits for [PII], [PII].
[CUSTOMER][NEUTRAL] So when you say hospital does that also cover the professional fees?
[AGENT][NEUTRAL] It's just any type of inpatient services.
[CUSTOMER][NEUTRAL] OK, um, and then if we could verify the address.
[CUSTOMER][NEUTRAL] For claims because I don't have a card.
[AGENT][NEUTRAL] It'll be [PII].
[AGENT][NEUTRAL] [PII] it's [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] it's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] is the zip.
[AGENT][NEUTRAL] Yes, that's correct, we have a payer ID as well.
[CUSTOMER][NEUTRAL] Um, OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so what happened to the [PII]?
[AGENT][NEUTRAL] This no longer exists. It was changed several years ago.
[CUSTOMER][NEUTRAL] OK, so that's super old because I've never seen this insurance in our system before, so I figured, do you have a fax option for secondaries?
[AGENT][NEUTRAL] No, we don't send any. I about to submit a claim to us. You can fax a claim to us.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] It's 1877.
[AGENT][NEUTRAL] 3659423. That's 187736594.
[AGENT][NEUTRAL] 23 attention claims department.
[CUSTOMER][NEUTRAL] And what is your name again?
[AGENT][NEUTRAL] [PII] and today's date as a reference.
[CUSTOMER][NEUTRAL] T
[CUSTOMER][POSITIVE] OK [PII], thank you so much for your help today.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. Have a great day. Goodbye.
[CUSTOMER][NEUTRAL] You too bye bye.