AccountId: 011433970860
ContactId: 0484a46a-9bec-4086-ae3f-460d48c300bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279170 ms
Total Talk Time (AGENT): 169409 ms
Total Talk Time (CUSTOMER): 117850 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/0484a46a-9bec-4086-ae3f-460d48c300bc_20250221T14:15_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII].
[CUSTOMER][NEUTRAL] Well you, I'm good. I'm trying to transfer a call to the HR department. What you getting it for?
[AGENT][NEUTRAL] Hey, how are you?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh boy, uh, I have no idea. You know, the HI doesn't exist no more. You need to go to, um, what's it called, the the the the the the uh APL support claim support. That's where they are.
[CUSTOMER][NEUTRAL] How do I, how do I get down?
[AGENT][NEUTRAL] It's in the in in the um quick connects it says uh APL claim support. The support team is the one that handles HI. Is it like a regular question or is it like a claim concern?
[CUSTOMER][NEUTRAL] OK, OK, weird.
[CUSTOMER][NEUTRAL] They want to know benefits and PPO network which I, I don't know all that. Mm mm.
[AGENT][POSITIVE] Oh, I can do that. Yeah, I can do that. I can do that. All right. [PII].
[CUSTOMER][NEUTRAL] Oh well, OK. I have [PII]. All right, yeah, I mean, I just don't know about, I don't know all this, but it's her name is [PII] and it's on policy number 025.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 972-227.
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] Patient is [PII] and uh let's see, [PII]'s callback number is gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so she's calling for benefits and network.
[CUSTOMER][NEUTRAL] Benefits and network.
[AGENT][NEUTRAL] OK. And did you get the place where she's coming from? Or no?
[CUSTOMER][NEUTRAL] Uh, she's calling from the doctor's office. She's, yeah, wanting to know, yeah, doctor's office.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] OK dokey. I'm ready for her. Thank you. Bye. You're welcome. You too. Have a good day. Bye-bye, Miss [PII].
[CUSTOMER][POSITIVE] All right, I'll leave it with you. Thank you, sir. Have a good one. All right, bye.
[AGENT][NEUTRAL] Good morning. This is so in the care team and is am I speaking with Miss [PII]?
[CUSTOMER][POSITIVE] Yes hi good morning how are you?
[AGENT][POSITIVE] I'm good, thank you. How about you?
[CUSTOMER][NEUTRAL] I'm good. I'm calling because I would like to know if we are in network with this member's plan.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, yes, Ms. [PII] gave me your callback number [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, sure, yes, I can assist you with benefit and network information and um she did provide me with the policy number and I need just need to verify the date of birth for the member.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, um, that will be, sorry, [PII].
[AGENT][NEUTRAL] OK, and can you just verify the name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, perfect. 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. Uh, this particular policy is one of our limited hospital indemnity plan. Uh, with this one, there's no network. If the provider participates with multi-plan, they get that additional discount but it is not required because we're not contracted.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and for the benefits, is this gonna be like an office visit?
[CUSTOMER][NEUTRAL] Yes, this office visit, um, especially, and it will be in [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so it looks like for an office visit, we cover a flat amount, which this is an indemnity plan, so it does cover just a flat amount. And the flat amount is $50 per visit, maximum of 4 visits per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK, is that a co-payment and or is that something that you guys are only gonna pay $50?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, we are only gonna pay the $50.
[CUSTOMER][NEUTRAL] So let's say the office visit is um 200, you guys only gonna pay the 50.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, is there any way I can give you the NPI number to see if we are in network or that's.
[AGENT][NEUTRAL] OK
[AGENT][NEGATIVE] There's no network. Yeah, yeah, we're not gonna.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK, so I'm just gonna give a call to the patient and let her know this information. Can I have a reference number?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, sure no problem.
[AGENT][NEUTRAL] Uh, we don't have reference numbers, Miss [PII]. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Um, yeah, please, sorry.
[AGENT][NEUTRAL] It's OK. My name is [PII]. That's [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] Thank you so much have a good day, OK?
[AGENT][POSITIVE] You're welcome. You as well, Miss [PII], and thank you for calling APL. bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] But