AccountId: 011433970860
ContactId: 030e0310-e228-4cd4-8e43-fb556c58543c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233229 ms
Total Talk Time (AGENT): 82029 ms
Total Talk Time (CUSTOMER): 65578 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/030e0310-e228-4cd4-8e43-fb556c58543c_20250411T14:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi Miss [PII], my name is [PII]. I'm calling from We Care Clinic. I'm just calling on behalf of a patient to verify her eligibility or if we're active, uh, we're active with her insurance.
[AGENT][NEUTRAL] OK, I can help you with eligibility. Did you say [PII], is that right?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, thank you. Do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] OK, do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] I do it's 026.
[CUSTOMER][NEUTRAL] 11231
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] Last name is [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Oh it looks like her policy is effective [PII]. It's currently active.
[AGENT][NEUTRAL] And were you needing benefits as well?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Get those pulled up. Is this for office visit or outpatient services or?
[CUSTOMER][NEUTRAL] Office visit one is busy.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment. It's a basic outline of the policy.
[AGENT][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so for physician's office visit, they have a $50 benefit and it pays out a maximum of $50 for office visits, max of $4 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And for a wellness
[AGENT][NEUTRAL] Um, for wellness.
[AGENT][NEGATIVE] I don't show any benefit for that.
[CUSTOMER][NEUTRAL] It does the insurance cover her wellness?
[AGENT][NEUTRAL] Um, no, this is, it's a hospital indemnity plan. It's like a supplemental policy, just pays for very limited things.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it doesn't cover her uh wellness visit then.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] We'll cover the physician
[CUSTOMER][NEUTRAL] If she were to do a wellness visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So she has it's like a $50 copay.
[AGENT][NEUTRAL] No, it's a $50 payout. That's the maximum it will pay out.
[AGENT][NEUTRAL] So the benefit
[CUSTOMER][NEUTRAL] The max that the insurance will pay is $50.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But she will be responsible for the rest.
[AGENT][NEUTRAL] Um, we, we don't determine patient responsibility. We just can tell you what the policy pays.
[CUSTOMER][NEUTRAL] OK perfect and then are we a network with her plan?
[AGENT][NEUTRAL] Um, there's no network.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Perfect and then can I have a reference number please?
[AGENT][NEUTRAL] The reference number is just my name, [PII], um, and today's date.
[CUSTOMER][NEUTRAL] And [PII] is with the STP sorry.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] At today's date?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you you too thank you so much.