AccountId: 011433970860
ContactId: 019f022d-54e4-47e2-80bf-c3ca0014ba22
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192970 ms
Total Talk Time (AGENT): 82700 ms
Total Talk Time (CUSTOMER): 66788 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/019f022d-54e4-47e2-80bf-c3ca0014ba22_20250305T18:22_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, um, my name is [PII]. I'm calling from Matthews View Medical Group billing office, and I'm calling to verify eligibility and benefits on a patient's, uh, APL secondary insurance.
[AGENT][POSITIVE] Sure, I can check eligibility and benefits for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, uh, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, uh, it is 02573216.
[AGENT][NEUTRAL] OK, and then uh what was the name and date of birth for the insured, please?
[CUSTOMER][NEUTRAL] All right, [PII]'s first name is [PII] Last name is [PII], [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. So this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at, uh, inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] Uh, this will be outpatient for uh PCP PCP primary care office visit.
[AGENT][NEUTRAL] OK, and of course I.
[AGENT][NEUTRAL] OK, um, one moment, uh, of course I will let you know verification of coverage is not a guarantee of payment for claims. Let me verify that office visits are covered under this policy. One moment please.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] OK. So that is not going to be a covered benefit under this policy, [PII]. Um, this for outpatient benefits, um, it's going to be like hospital emergency rooms, urgent care, uh, surgery, uh, physician's office or specialist office visits are not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so primary care and specialty care office visits not covered?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so this, so this is what, um, OK, uh, so this would be more like a major medical secondary insurance, right?
[AGENT][NEUTRAL] Yes, this is secondary to major medical.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Alrighty then, can I get a call reference number please?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that'll be it. I appreciate your help.
[AGENT][POSITIVE] Alright, yeah, thanks for calling [PII]. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too alrighty bye bye.
[AGENT][POSITIVE] Thank you, bye bye.