AccountId: 011433970860
ContactId: 07065140-a19a-4140-923e-b0a3e4b84bd4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 585520 ms
Total Talk Time (AGENT): 252035 ms
Total Talk Time (CUSTOMER): 180486 ms
Interruptions: 4
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/07065140-a19a-4140-923e-b0a3e4b84bd4_20250217T21:30_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good, good evening, [PII]. My name is [PII]. I was just trying to make sure that uh I was in that the urgent care that I'm at, that they accept this in-network. I don't know cause she had a hard time finding.
[AGENT][NEUTRAL] OK, so you're needing to find out about something related to being in network, is that correct, [PII]?
[CUSTOMER][NEUTRAL] In the system.
[CUSTOMER][NEGATIVE] Yes, in work, yes, cause I'm, I'm not feeling well. I'm really, I'm not feeling well. I'm sick. Just trying to see if I'm in the right network of the uh fast paced.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] I'm so sorry.
[AGENT][NEUTRAL] OK, so now,
[AGENT][NEUTRAL] Alright, [PII], I can try and help you with this, um, but it's, but I will have to pull up your policy information first and verify some things with you for security. So first off, [PII], what is your last name?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Thank you and what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is your policy number please, Miss [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Hold on, let me see. Give me one moment.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] My policy number is 02579867.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, Ms. [PII], so first off, any information that I do provide would be a verification of benefits and not a guarantee of payment. What is your date of birth?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Also your home mailing address please.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Thank you. The phone number we have for you is the same as the one you gave me, so that is your best contact number, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] All right. Thank you. And lastly, your email address please, Ms. [PII].
[CUSTOMER][NEUTRAL] It's uh [PII] was the [PII] name, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. Now Ms. [PII], for the well first off, um, have you ever set up your profile in our portal here at APL so you can have access to your ID cards and stuff online? OK, well I'm gonna email you the user guide. I know you're not feeling well, so I'm gonna email that user guide to you so when you're feeling better you can set that up because it will give you access to your ID cards and stuff also but the policy this limited benefit plan that you have with APL.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I haven't, no.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You're not in a network.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There is no network with this plan, so you can select any provider to go to.
[CUSTOMER][NEUTRAL] OK, cause she said she didn't know like it was taking so long, but do you think I need to let her know it's not in network or how would I confirm it?
[AGENT][NEUTRAL] If
[AGENT][NEUTRAL] If you want to, um, let me see, I don't let me see if anyone has called us related to your.
[CUSTOMER][NEUTRAL] Confirm it.
[AGENT][NEGATIVE] I don't see what we've received, uh.
[CUSTOMER][NEUTRAL] I think she said she reached out.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I don't see where anyone has called us. I see where you had called earlier and got a mailing address and the payer ID number and all of that, but I don't see where we've received a call from a provider. Do you want me to remain on the line while you speak with her?
[CUSTOMER][NEUTRAL] Did
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah, yeah, I can just let you speak with her. I'm just right, right here. I just had to walk outside.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let you speak with her cause she said she reached out to somebody but she don't know how long it would take. But let me.
[AGENT][NEUTRAL] Oh, I don't know about that. Now, Miss [PII], I just wanna tell you before you give the phone to anyone else, the email that I'm gonna send to you is gonna come from [PII] team at [PII], and I will put APL in your subject line so that that's easy for you to recognize, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] And I've just actually sent it. You're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Give me one moment, somebody ahead of me.
[AGENT][NEUTRAL] Oh, you're
[AGENT][POSITIVE] You're OK.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I have her on the phone. Yeah. Thank you. Hello.
[AGENT][NEUTRAL] Hi, who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], [PII], this is [PII] with APL.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, Ms. [PII] was calling to find out about Network. She said that someone had called APL, but I don't see where we've received a call to verify her eligibility or benefit information.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] She called them.
[AGENT][NEUTRAL] OK, I'm not, OK, the policy is active. Her policy that she has with APL is active, and this is not a network plan. This is a limited benefit plan that she has, but there is no network, so she might select any provider.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so what is like a copay or anything like that she has or a deductible that hasn't been met?
[AGENT][NEUTRAL] Again, this
[AGENT][NEUTRAL] Again, this is not major medical insurance. It's a limited benefit plan and her benefit for an urgent care visit is a $75 visit per day and a max of 6 days per calendar year for covered person. And any information that I have provided, [PII], to you or Ms. [PII] as she, as I've already explained to her, would be a verification of benefits and not a guarantee of payment.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] And we're coming to.
[CUSTOMER][NEUTRAL] OK, so the 75 per day, um.
[AGENT][NEUTRAL] That is the benefit on this policy.
[CUSTOMER][NEUTRAL] When was her active date?
[AGENT][NEUTRAL] The effective date on this plan is [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And you said there is not a deductible because it's a limited benefit plan.
[AGENT][POSITIVE] That is, that is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] And your name one more time?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And if you all do submit a claim with APL for her, uh, once the claim has been processed, we do have a portal camera that you all should be able to check claim status in by going to secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm, OK, yeah, that's something our billing department does we don't handle any of that, um, OK, thank you so much mhm bye.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you are certainly welcome. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] And did Ms. [PII] have any additional questions?
[CUSTOMER][NEUTRAL] No, I don't.
[AGENT][POSITIVE] OK, Miss [PII], well, I hope you feel better and if that's all that I can help you with, thank you again for calling APL and I hope you have a nice evening.
[CUSTOMER][POSITIVE] OK, thank you. You really took care of everything. I really appreciate your help.
[AGENT][POSITIVE] Oh, well, you're certainly very welcome. It was my pleasure.
[CUSTOMER][POSITIVE] OK. You have a good day. Bye-bye. Mhm.
[AGENT][NEUTRAL] OK. Yes, ma'am. You too. Bye-bye.
[CUSTOMER][POSITIVE] Thank you, bye.
[AGENT][POSITIVE] You're welcome. Bye-bye