AccountId: 011433970860
ContactId: 01c7694f-c672-4714-961a-cbc918d2a87f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233080 ms
Total Talk Time (AGENT): 123267 ms
Total Talk Time (CUSTOMER): 67519 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/01c7694f-c672-4714-961a-cbc918d2a87f_20250131T16:06_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Morning. Thank you for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the Long Street clinic to verify eligibility and benefits.
[AGENT][NEUTRAL] OK, sure. Uh, I can assist you with eligibility and benefits, Miss [PII] and I'm sorry, I didn't get the name of the clinic.
[CUSTOMER][NEUTRAL] At the Long Street clinic.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02549863
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, [PII], date of birth [PII].
[AGENT][NEUTRAL] Thank you, Miss [PII]. All right, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer. Um, we have an effective date of [PII]. It is active at the moment and this is one of our hospital indemnity plan. And let me give you the benefits on.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK for an office visit, we cover $75 per visit, maximum of 5 visits per person per calendar year.
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat that?
[AGENT][NEUTRAL] Sure, yes, mhm, we cover $75 per visit.
[AGENT][NEUTRAL] Maximum of 5 visits per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] And does this plan have um a deductible or an out of pocket maximum?
[AGENT][NEUTRAL] No, this is not a major medical. This is a limited indemnity plan, so it pays flat amount.
[AGENT][NEUTRAL] And the flat amount is $75 so anything remaining or anything over is up to the provider's discretion.
[CUSTOMER][NEUTRAL] OK, yes ma'am, and um could you confirm the payer ID and the address for claims?
[AGENT][NEUTRAL] Mm, sure.
[AGENT][NEUTRAL] Let me get that for you. OK. The mailing address, this one goes to IMA before it comes to us. So that will be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The payer ID is 64556.
[CUSTOMER][NEUTRAL] OK, and then just to confirm this policy, um, it's using the multi plan um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Network correct.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I think that is all the information that I needed. Could I just get your name and a call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date. My name is [PII]. That's [PII]. Last [PII] is [PII]. Is there anything else I may help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Uh no, ma'am, that's all.
[AGENT][POSITIVE] OK, well thank you for calling APL. Have a good weekend.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you. Mm bye.