AccountId: 011433970860
ContactId: 0497cef6-a999-487b-8912-21c5869d4e0d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168830 ms
Total Talk Time (AGENT): 84156 ms
Total Talk Time (CUSTOMER): 82869 ms
Interruptions: 5
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/0497cef6-a999-487b-8912-21c5869d4e0d_20250425T15:02_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with Lex and Valley Medicine. I am trying to, uh, I'm checking eligibility on a patient.
[AGENT][NEUTRAL] OK. Happy to check eligibility. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yes. It is 02217767.
[AGENT][POSITIVE] OK, thank you so much. Let me pull this up.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And can I get the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And we're looking for medical or dental coverage?
[CUSTOMER][NEUTRAL] Um, medical coverage.
[AGENT][NEUTRAL] OK, great. Uh, patient does have an active plan with us. Effective date on here is [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and is there any co-pay with his with the patients, um.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, what do you call it? Policy, I'm sorry.
[AGENT][NEUTRAL] That's OK, um, so the patient has a limited benefit plan, hospital indemnity, so it's just gonna pay a set amount depending upon what they're being seen for. Are they coming in for like an office visit?
[CUSTOMER][NEUTRAL] Yes I have.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh, it looks like a follow up, a follow up visit. Yes, yes, it is an office visit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. Um, so it looks like the patient.
[AGENT][NEUTRAL] I allowed a maximum of 5 visits in a calendar year.
[AGENT][NEUTRAL] And each visit will pay a benefit amount it looks like of $75.
[CUSTOMER][NEUTRAL] For each visit?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And that's only after insurance taking care of theirs or is, is this considered the copay?
[AGENT][NEUTRAL] So this is gonna pay $75 towards whatever the fee is for the office visit. We don't have, you know, of course what that information is. So if the.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Charges are $200 and we pay $75 towards that and then the rest would be up to the provider to, you know, deem patient responsibility if they wanted to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, well that makes sense.
[CUSTOMER][POSITIVE] Um, all right, well, that is the information I needed. Thank you very much.
[AGENT][POSITIVE] Yeah, not a problem. Anything else?
[CUSTOMER][NEUTRAL] Uh, not at this moment. Let me see if I have another patient with the same insurance. Nope, I don't. Nope, that's it.
[AGENT][POSITIVE] Alright, sounds good. Well, thanks for calling. Hope you have a good rest of your day and a great weekend.
[CUSTOMER][POSITIVE] You too thank you bye.
[AGENT][NEUTRAL] Bye-bye.