AccountId: 011433970860
ContactId: 0916079f-2ce7-4209-8c49-3acf392bb044
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300000 ms
Total Talk Time (AGENT): 123118 ms
Total Talk Time (CUSTOMER): 98185 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/0916079f-2ce7-4209-8c49-3acf392bb044_20250324T14:35_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] Yeah.
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling because we, we were just provided this insurance today. um, I just wanted to verify and see if we're a network and um if they're active.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] It would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII], and a good callback number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. And [PII], what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's 02589641.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, her first name is [PII]. Date of birth uh last name [PII], and date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, and I can help you with that eligibility for [PII]. I'm showing that her policy is active. Effective date is
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Anything else I can help you with?
[CUSTOMER][NEUTRAL] Yes, I wanted to see if we're a network or what their responsibility is if they have one, as well.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] And I can help you with that benefit information also.
[AGENT][NEUTRAL] Now, this policy is a limited hospital indemnity policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] There is no network.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] I'm trying to get those benefits pulled up. I do apologize.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What type of benefits are you needing?
[CUSTOMER][NEUTRAL] Well, they're here. It's a um this is her pri primary care provider and she's here for like a regular sickquisite.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright hold on let me see.
[CUSTOMER][NEUTRAL] Actually she's here for.
[CUSTOMER][NEUTRAL] Her sorry, I'm sorry she's here for uh well checking vaccine, so preventative.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And you.
[AGENT][POSITIVE] And I do apologize. My system is going very slow this morning, so bear with me.
[CUSTOMER][NEUTRAL] Mhm OK.
[AGENT][NEUTRAL] So she does have a primary physician's visit.
[AGENT][NEUTRAL] For office visit we pay $75 per day maximum of 6 days per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, what about um for preventative?
[AGENT][NEUTRAL] Uh, the policy is going to pay for accident and sickness only.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, so this is just accident and sickness. This plan is just for accident and sickness?
[AGENT][NEUTRAL] Yeah, let me check one other thing.
[CUSTOMER][NEUTRAL] and the
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] I apologize. Hang on just a second.
[CUSTOMER][NEUTRAL] So what do you need? Do you have ID?
[CUSTOMER][NEUTRAL] T
[AGENT][NEUTRAL] OK, she does have a health screening benefit of $150 per day.
[AGENT][NEUTRAL] But that is uh one day per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And that's for screening benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there a payer ID um for the claims address?
[AGENT][NEUTRAL] Mhm, the payer ID is 60801.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you would also please note, [PII], all benefits given over the phone is a verification the coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK and go ahead.
[CUSTOMER][POSITIVE] Perfect. OK, I think that's all I need just a reference number please.
[AGENT][NEUTRAL] Reference number is my name today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] And it's been a pleasure to assist you with those benefits. Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] No ma'am that's it thank you.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too thanks.