AccountId: 011433970860
ContactId: 0ca32000-5765-4ea8-811a-d4456a4f6789
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 261798 ms
Total Talk Time (AGENT): 113495 ms
Total Talk Time (CUSTOMER): 82883 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/0ca32000-5765-4ea8-811a-d4456a4f6789_20250213T16:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Did you say [PII]?
[AGENT][NEUTRAL] Uh, [PII]
[CUSTOMER][POSITIVE] Oh, I'm so sorry. Yes, [PII], I need to get eligibility and benefits for a patient please.
[AGENT][NEUTRAL] That's OK
[AGENT][NEUTRAL] Sure, I can check eligibility and benefits for you. um, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] I do. It's D as in David 41601802.
[AGENT][NEUTRAL] OK, so that is actually not one of our policy numbers [PII]. That is through, um, they're called 90 Degrees. Um, I could see if they have a policy with us. Do you have their social? I could search that way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Give me one minute, it is.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And what was the name for the patient?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have the date of birth?
[CUSTOMER][NEUTRAL] Oh ho, I just got off that. I've been looking at the card, um, [PII].
[AGENT][POSITIVE] Perfect. OK, thank you for verifying that and this was for uh medical correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so yes, he does have a policy with us. Um, it is a limited indemnity medical plan. Um, its effective date was [PII], and it is currently active.
[AGENT][NEUTRAL] Are we needing to check specific benefits?
[CUSTOMER][NEUTRAL] OK, it's a limited identity.
[CUSTOMER][NEUTRAL] Um, just medical office visit, um.
[CUSTOMER][NEUTRAL] When you say medical indemnity, usually they have so many visits per year and they only pay at a certain limited amount. Does it specify between wellness and and illness?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Most of the time they do. Um, let me get this policy pulled up, um, and we will take a look. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And was this just for an actual physician's office, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So yes, this one physician's office, it is gonna be uh $50 max per day and that is limited to 4 days per calendar year.
[AGENT][NEUTRAL] And I can see I know we're still kind of early in the year but I can double check to see if any of that has been used.
[AGENT][NEUTRAL] OK, none has been used so far this year.
[CUSTOMER][NEUTRAL] And does he have any wellness visit?
[CUSTOMER][NEUTRAL] Or is is is that included in the max?
[AGENT][NEUTRAL] That would be included. It's not separate on this one. It's just that $50 per office visit.
[CUSTOMER][NEUTRAL] Office visit, uh, sick or includes sick or.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] sick Orwell.
[CUSTOMER][NEUTRAL] OK, alrighty, and do you have a call reference number or anything that I could use please?
[AGENT][NEUTRAL] Yeah, it would just be my first name, last initial and today's date, uh, so my last initial is [PII] was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, no, no, ma'am, you've answered my questions. I appreciate it so much. You have a wonderful day, OK?
[AGENT][NEUTRAL] OK. All right, yeah.
[AGENT][POSITIVE] Yeah, thanks for calling APO you too bye bye.
[CUSTOMER][POSITIVE] Have a good weekend thank you bye bye.
[AGENT][POSITIVE] You too, thanks. Bye bye.