AccountId: 011433970860
ContactId: 08860e77-4e30-4528-97e6-5fdce9d9466e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198690 ms
Total Talk Time (AGENT): 80031 ms
Total Talk Time (CUSTOMER): 55586 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/08860e77-4e30-4528-97e6-5fdce9d9466e_20250623T20:33_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling with ABC Pediatrics. I just wanted to verify if our provider was the network with this policy.
[AGENT][POSITIVE] Alright, [PII], I'm happy to check. Do you have the policy number for the number?
[CUSTOMER][NEUTRAL] Yes, I have 02623413.
[AGENT][NEUTRAL] OK. Let me pull that up.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. All right, [PII], so they are active. Effective date on here is [PII].
[AGENT][NEUTRAL] The member's plan is a limited benefit medical plan, so there's no network required for usage, it's just gonna pay a set amount depending upon what they're being seen or treated for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, it doesn't matter if our providers are in network or out of network.
[AGENT][NEGATIVE] Yeah, there's no network on this plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um what would be the benefits for like a preventative visit with immunization?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] All right. So it looks like uh the plan is gonna pay $50 towards the office visit.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the patient does have um a total of 4 visits that are allowed per calendar year.
[CUSTOMER][NEUTRAL] In those office visits, does that include like a routine physical? OK.
[AGENT][NEUTRAL] Mhm, yeah, that would fall under that same category.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um the vaccines as well will fall in the same thing.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and is there like a copay for an office visit?
[AGENT][NEUTRAL] No, so the plan just pays the $50 towards the office visit. There, yeah, there's no co-pay. It's just up to the provider to decide what the patient responsibility is.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect and lastly, may I have your reference number for our call?
[AGENT][NEUTRAL] Absolutely. Call references my name with today's date. My name again is [PII], that's [PII] Last initial is [PII] like [PII], and then today's date.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Perfect thank you so much for your help, Miss [PII].
[AGENT][POSITIVE] You're welcome have a good one.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.