AccountId: 011433970860
ContactId: 08fb9529-9821-4b83-9798-f15ce7af2454
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230990 ms
Total Talk Time (AGENT): 103102 ms
Total Talk Time (CUSTOMER): 76534 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/08fb9529-9821-4b83-9798-f15ce7af2454_20250409T15:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] from Austin Regional Clinic. I'm calling to verify a patient's eligibility and benefits.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, give me one second. The number will be [PII].
[AGENT][NEUTRAL] OK, and the member's policy number?
[CUSTOMER][NEUTRAL] Policy number will be
[CUSTOMER][NEUTRAL] 02584614
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, and the date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Well, did you say [PII] or [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, OK, got you.
[CUSTOMER][NEUTRAL] Um, so I just need the, um, well you gave me the eligibility, um, I just need to know what are the co-pays, if there's any in office visit copay, um, just regular, and then the specialty copays as well.
[AGENT][NEUTRAL] OK, so this is, um, so there's no co-pay for this policy, it's a hospital indemnity policy. Um, I mean, I can tell you the coverage for like the office, but there's no, this isn't like a major insurance, there's no co-pay or out of pocket for this.
[CUSTOMER][NEUTRAL] So is this like only for like emergencies and uh hospital?
[AGENT][NEUTRAL] No, um, I mean, there is a hospital confinement or intensive care, but they do have wellness benefits and office visit benefits, um, surgery benefits as well.
[CUSTOMER][NEUTRAL] OK, uh, I'll take the office visits.
[AGENT][NEUTRAL] OK. Um, so the max is $75 per visit with a max of 5 visits per calendar year, and this is per person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And they are under multiplan.
[AGENT][NEUTRAL] Um, let me see if this one is under multiplan.
[AGENT][NEUTRAL] Yes, this one does have the PPO network through multiplan um to see if your provider is in network. I do have multilann's phone number or um website if you need it.
[CUSTOMER][NEUTRAL] OK, so we are in network with multi multi plan. I was just double checking, um.
[AGENT][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] And I think that's pretty much all. Is there a reference number for the call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. Um again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Alrighty, well thank you so much.
[AGENT][POSITIVE] You're very welcome, [PII] and thanks for calling APL. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, no, that was all.
[AGENT][POSITIVE] Alright well I hope you have a great day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. You're welcome. Bye bye.