AccountId: 011433970860
ContactId: 00904481-762d-4c85-ba97-704f03fc90c7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221889 ms
Total Talk Time (AGENT): 88061 ms
Total Talk Time (CUSTOMER): 72915 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/00904481-762d-4c85-ba97-704f03fc90c7_20250214T18:54_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], hi, my name is [PII]. I'm calling from Doctor [PII]'s office. I needed to verify coverage on a patient, please.
[AGENT][NEUTRAL] OK, I can help with that, Miss [PII]. What is your callback number if we were disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I please have the policy number?
[CUSTOMER][NEUTRAL] 02269758
[AGENT][NEUTRAL] OK, I have that as 02269758.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Thank you, verify the patient.
[CUSTOMER][NEUTRAL] Oh, this same thing.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the date of birth?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you very much for the information and you're calling for eligibility for dental or medical?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] Medical, OK.
[AGENT][NEUTRAL] That was the dental policy number. Give me one moment please, [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I show the medical policy number which I can provide that to you when you're ready.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, it is 02487919.
[CUSTOMER][NEUTRAL] It's 02487919.
[AGENT][NEUTRAL] Yes, and the policy shows effective as of [PII] and it shows active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what benefit would you need, please?
[CUSTOMER][NEUTRAL] Um, I guess the pay how you pay, what, what generally, what does the probably consist of it for reimbursement.
[AGENT][NEUTRAL] OK, would this be for an office visit?
[CUSTOMER][NEUTRAL] Office visit, uh-huh.
[AGENT][NEUTRAL] OK, OK, thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I think it was OK.
[AGENT][NEUTRAL] OK, thank you so much for your patience. Please note verification, uh, thank you. Verification of benefits provided does not guarantee payment. We pay a benefit maximum of $75 for a visit. The member is allowed 6 visits per year.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Now, let me just ask you this, the maximum that you are allowed, can we charge the patients the difference of what our normal standard office visit is?
[AGENT][NEUTRAL] We pay $75 regardless.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] So can you not answer that particular question? You know, if it's, it's 125, 175, we could charge him the additional 100 if you all just pay the 75.
[AGENT][NEUTRAL] Well, I can only advise you that we pay $75 for an office visit, which that's the benefit, yes ma'am.
[CUSTOMER][POSITIVE] OK, I got you. OK. All right, [PII], I appreciate it. Thank you so much for your time.
[AGENT][POSITIVE] You're welcome, Miss [PII]. Thank you for calling APL. Take care. Mm bye.
[CUSTOMER][NEUTRAL] OK, bye.