AccountId: 011433970860
ContactId: 073d1c1c-75b4-4eac-bf16-c3f572e76bc0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198820 ms
Total Talk Time (AGENT): 84010 ms
Total Talk Time (CUSTOMER): 84419 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/073d1c1c-75b4-4eac-bf16-c3f572e76bc0_20250213T14:13_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Good morning. This is [PII] with Gri eye Care. How are you today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] Good I am calling about a mutual patient to verify eligibility.
[AGENT][NEUTRAL] OK, can you spell your name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you said you're needing eligibility and benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and the policy number for the patient?
[CUSTOMER][NEUTRAL] It's gonna be 02573485.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and now we'll go ahead and verify the patient if you can give me their name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. We have up his file and we can verify the information. I'm showing the effective date is [PII]. Uh, this policy is active at this time.
[AGENT][NEUTRAL] And for service in a physician's office?
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] The office visit fee is not covered, um, but if there's treatment in the office, covered treatment can be considered.
[CUSTOMER][NEUTRAL] OK, and that's gonna be for the specialist office visit is the same benefit?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And for submitting claims, where should I submit those?
[AGENT][NEUTRAL] Mhm. To American Public Life.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] PO Box.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 248
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oklahoma City, Oklahoma.
[AGENT][NEUTRAL] 73124.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 8950.
[CUSTOMER][NEUTRAL] OK, and the other thing would be to see, is this like a PPO policy for him and primary for him?
[AGENT][NEUTRAL] It's a MetLink.
[AGENT][NEUTRAL] No, it's a Metlink policy secondary to the primary insurance.
[CUSTOMER][NEUTRAL] Mm, would you happen to know what the primary is for him?
[AGENT][NEUTRAL] I'll verify if we have that information and of course, you wanna check with the patient as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm showing UHC.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I appreciate that.
[AGENT][NEUTRAL] All right. Anything else covers?
[CUSTOMER][NEUTRAL] And I just need a reference, just a reference number.
[AGENT][NEUTRAL] OK. You'll use my name in today's date. uh [PII] and last name is [PII].
[CUSTOMER][POSITIVE] OK, and thank you so much for the information, enjoy the rest of your day.
[AGENT][POSITIVE] You too, thanks for calling APL [PII]. Have a good day as well.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye. Bye