AccountId: 011433970860
ContactId: 052fd16d-41c9-4a11-aaba-7f9bb63be88b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379130 ms
Total Talk Time (AGENT): 160298 ms
Total Talk Time (CUSTOMER): 239926 ms
Interruptions: 7
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/052fd16d-41c9-4a11-aaba-7f9bb63be88b_20250328T15:54_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APO. This is [PII]. How may I assist?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. My last initial is [PII]. I'm calling from Piedmontron Care about, and I'm calling to verify eligibility for insurance for this patient is being seen in our office today. I can give you a call.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, yes, I can assist you with eligibility. And may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII] so I'm gonna write you down.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] Yes, it is D 437-22899.
[CUSTOMER][NEUTRAL] 25 or 2?
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with the 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Wait, hold on, let me see. I see employee employee ID. I'm sorry. Group number, employee name, medical coverage, employee.
[CUSTOMER][POSITIVE] Hey. You good.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Actually, I don't see a policy number on here.
[AGENT][NEUTRAL] Mm, OK. Was this
[CUSTOMER][NEUTRAL] I don't see a policy number on here.
[AGENT][NEUTRAL] OK. What's the spelling of the last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. And what's the spelling of the first name?
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK, and let me have the spelling of your name so I can spell it correctly.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, [PII]
[CUSTOMER][NEUTRAL] [PII] and my last initial is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Give me one moment. Let me see if I can find his number with that information.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] finishing on my side and don't put in here but
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I mean, I don't think but
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, I
[AGENT][NEUTRAL] Is he the main holder?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mr. [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, he's supposed to be.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] I'm not finding him uh in the system.
[CUSTOMER][NEUTRAL] Right, that's what I was wondering too, cause like I said, I'm not seeing even a member ID and I know normally they have it, so that's why I thought it might be the ID number I gave you, but well, let me see.
[AGENT][NEUTRAL] You might wanna check with um I IMA uh that the number is for IMA but IMA usually handles only preventative.
[CUSTOMER][NEUTRAL] Let
[AGENT][NEUTRAL] Um, but yeah, I'm not.
[CUSTOMER][NEUTRAL] Let's try the, let's try the last name again because on the card itself they have it misspelled so it may show up with that. Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. Go ahead.
[CUSTOMER][NEUTRAL] So it's [PII] and on the card it has [PII].
[AGENT][NEUTRAL] [PII], OK, OK, bear with me just a second.
[CUSTOMER][NEUTRAL] So if it's something they've seen before, something that could be, you know, anything really you really don't know um.
[AGENT][NEUTRAL] Yeah, I think it's this one.
[AGENT][NEUTRAL] All right. What's his date of birth?
[CUSTOMER][NEUTRAL] OK, so it's because they had it misspelled. It is [PII]. Um, if y'all wanna go ahead and put your name on that.
[AGENT][NEUTRAL] Yup. Here he is. All right. And this is, uh, you need eligibility and this is for medical, correct?
[CUSTOMER][NEUTRAL] those
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right. OK. So let's see. We have an effective date of [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it is active at the moment.
[CUSTOMER][NEUTRAL] Alright, and then you can have the.
[AGENT][NEUTRAL] And this is a limited hospital indemnity plan.
[CUSTOMER][NEUTRAL] It says to limit that hospital indemnity plan.
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And he is eligible to be seen in our office. We are prompt care.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] If it's an urgent care.
[CUSTOMER][NEUTRAL] Mhm. It's technically not care, but it's basically like the same thing. OK.
[AGENT][POSITIVE] Yes, um, we do have benefits for.
[AGENT][NEUTRAL] It's office. OK. Do you need benefit information? No.
[CUSTOMER][NEUTRAL] Um, what's his member ID since I wasn't able to get with that number? Do you have that?
[AGENT][NEUTRAL] Uh, yes, I do. Um, that is policy number 0254.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] 563 3.
[CUSTOMER][NEUTRAL] Mhm. OK, that was 02545633.
[AGENT][POSITIVE] 563, yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And is there um a copay or anything because like I said, the card is not showing me anything whatsoever.
[AGENT][NEUTRAL] Mm. No, this one doesn't have any co-payments, co-insurance, or deductibles. This one is an indemnity policy, so it pays a flat amount, and this is not a guarantee of payment, just a verification of coverage. It looks like we cover $75 per visit, maximum of 5 visits per covered person per calendar year, and this is combined benefit with specialist, urgent care, um, regular PCP and ER visits.
[CUSTOMER][NEUTRAL] uh
[CUSTOMER][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] I just now.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I may help you with today, Mister?
[CUSTOMER][NEUTRAL] Um, is there a reference number there?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you would like.
[CUSTOMER][NEUTRAL] OK, and can you spell your name for me correctly, please?
[AGENT][NEUTRAL] Oh sure. That's [PII].
[CUSTOMER][POSITIVE] OK, alrighty, thank you so much for that.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good weekend, Mr. [PII].
[CUSTOMER][NEUTRAL] Oh, I don't know
[CUSTOMER][POSITIVE] Yes, ma'am. You as well.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah