AccountId: 011433970860
ContactId: 0bc237c3-0eb6-4ebb-9764-1c0bb35ef241
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272369 ms
Total Talk Time (AGENT): 99820 ms
Total Talk Time (CUSTOMER): 115388 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/0bc237c3-0eb6-4ebb-9764-1c0bb35ef241_20250121T16:56_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] OK, [PII], my name is [PII] and I work with Lane Family Clinic in [PII].
[CUSTOMER][NEUTRAL] And I am, uh, we have a patient here that has you you guys' insurance.
[CUSTOMER][NEUTRAL] And I'm trying to verify that um.
[CUSTOMER][NEUTRAL] That the insurance is.
[CUSTOMER][NEUTRAL] Uh, good or whatever, um, and then try to do it in my system. I can't find it and I know it's something that they have to do to unlock, but I'm just trying to verify that she does have insurance.
[AGENT][POSITIVE] I'd be happy to assist with eligibility today [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 981-2104
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy
[CUSTOMER][NEUTRAL] OK, 02351654.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, [PII], date of birth [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII].
[AGENT][NEUTRAL] And this and this is for outpatient office visit that you're calling in reference to?
[CUSTOMER][NEUTRAL] Yes, she's in our uh office at the moment. The thing is is that we have a new system and they hadn't unlocked um for us for this insurance yet, so I'm gonna have to call them to have them to unlock it and I was just trying to verify before um she was seen.
[AGENT][NEUTRAL] OK, now I do show that with her policy she only has benefits.
[AGENT][NEUTRAL] Uh, for treatment in an office setting if it's a surgical procedure.
[AGENT][NEUTRAL] She does not have regular doctor's office benefits with this policy. This is a limited benefit hospital indemnity plan.
[CUSTOMER][NEGATIVE] Hm, OK, let's see what this one is. OK, so I'm gonna have to call I'm and they ain't even.
[CUSTOMER][NEUTRAL] Uh, hold on.
[CUSTOMER][NEUTRAL] And it's, so it's 90 degrees with you guys too?
[AGENT][NEUTRAL] Um, 90 degree benefits, um, yeah, they're affiliated with us, but they're not us.
[CUSTOMER][NEUTRAL] OK, so who do I contact on it because she gave me both of these. One is 90 and one is ATL.
[AGENT][NEUTRAL] OK, well, we're APL, um, they, there should be a number for the 90 degree benefits on the card. Um, if not, I have that number is, does it also say IMA?
[CUSTOMER][NEUTRAL] I am a.
[CUSTOMER][NEUTRAL] Let me see
[AGENT][NEUTRAL] Or multiplan?
[CUSTOMER][NEUTRAL] I don't see that on there.
[CUSTOMER][NEUTRAL] Hold on 1 2nd.
[CUSTOMER][NEUTRAL] Medical.
[CUSTOMER][NEUTRAL] I don't see IMA on here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you talking about on ATL?
[AGENT][NEUTRAL] No, no, you were, you were asking in regards to I don't have enough for 90 degree benefits.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] About the 90 degrees, yeah, yeah, I don't see that on here.
[AGENT][NEUTRAL] But I believe that 90 degrees would be the net network.
[CUSTOMER][NEUTRAL] OK, um, can you give me their number?
[AGENT][NEUTRAL] But we process the claims.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so,
[CUSTOMER][NEUTRAL] Oh, well, on your APL it says attention IMA Inc.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Because that's where the claims go for pricing because I am IMA or 90 Degrees benefits is the network but we process the claims or after they reprice the claims then we they send them to us for processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Network, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, can you give me that number because the number I called it wouldn't go through for some reason.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] That's the fax number.
[AGENT][NEUTRAL] So the number for multi plan is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][NEUTRAL] Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too.