AccountId: 011433970860
ContactId: 126b9681-f047-4dc4-9d4d-ec1af9704c62
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 465329 ms
Total Talk Time (AGENT): 178250 ms
Total Talk Time (CUSTOMER): 275984 ms
Interruptions: 6
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/126b9681-f047-4dc4-9d4d-ec1af9704c62_20250423T15:18_UTC.wav
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[CUSTOMER][NEUTRAL] And of course he will.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] you will fill out.
[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] You know what? I'm so sorry you broke up the whole time when you were talking.
[AGENT][POSITIVE] Oh, I'm so sorry. My name is [PII]. I'm with APL. How can I help you?
[CUSTOMER][NEUTRAL] They might have a all all you have.
[CUSTOMER][NEUTRAL] Uh, hi [PII], um, I'm calling from a doctor's office trying to check on um the eligibility of a patient, um, she said this is a a new insurance that she has, um, and that, so, um, I was trying to check um if she's active.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, her effective date if it's a PPO or an HMO, uh, and she wanted to know if she had a copay.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, can I can help you with the eligibility and the benefits for the patient. Can you please give me your name and your callback number?
[CUSTOMER][NEUTRAL] You're coming in.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] My name is [PII]. My callback number is [PII].
[AGENT][NEUTRAL] Thank you. And then may I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK, her date of birth is [PII], and um she gave me her policy number is 02608910.
[CUSTOMER][NEUTRAL] Once we get the medical records, I will.
[AGENT][NEUTRAL] 02608940 what was it?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 10.
[CUSTOMER][NEUTRAL] 02608910.
[AGENT][POSITIVE] 10. OK, thank you.
[CUSTOMER][NEUTRAL] Me too and.
[AGENT][NEUTRAL] OK and then what is her name? And.
[CUSTOMER][NEUTRAL] Her name is [PII].
[CUSTOMER][NEUTRAL] they they won't process anything until.
[AGENT][NEUTRAL] OK, let me look her up real quick.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] What type of insurance
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us. Her effective date is [PII].
[CUSTOMER][NEUTRAL] Ok, did they already have to OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So I, I can give you.
[CUSTOMER][POSITIVE] And I'm so sorry, what was March what?
[AGENT][NEUTRAL] And this is
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] have
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] right now.
[AGENT][NEUTRAL] Yes ma'am, and this is just to verify her benefits. It's not a guarantee of payment, um.
[CUSTOMER][NEUTRAL] The providers that are
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Nurse practitioner.
[AGENT][NEUTRAL] I'm checking she wants to know if she has any deductible or copay, is that correct?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, yes, she was, uh, she was asking if she's gonna have to pay anything at the visit.
[AGENT][NEUTRAL] OK, so is she going inpatient or outpatient?
[CUSTOMER][NEUTRAL] She is coming to see her primary uh care provider for an office visit.
[AGENT][NEUTRAL] OK, alright, that gives me, OK, and this is just to verify her benefits. It's not a guarantee of payment. This is a hospital indemnity plan.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You know what, you, you keep breaking out on me sorry.
[AGENT][NEUTRAL] Oh, OK, hold on, let me see if I can fix that real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Check out for Charlie and then make an appointment.
[AGENT][POSITIVE] OK, thank you so much. This is.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Benefit hospital indemnity plan.
[CUSTOMER][NEUTRAL] This is uh OK, say it again limited?
[AGENT][NEUTRAL] Limited benefit hospital and.
[CUSTOMER][NEUTRAL] Did you say limited plan?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, hospital indemnity plan.
[CUSTOMER][NEUTRAL] And in
[CUSTOMER][NEGATIVE] Damnity plan.
[CUSTOMER][NEUTRAL] OK, limited hospital benefits indemnity plan, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And she
[AGENT][NEUTRAL] Yes, ma'am. And she does have um a physician offices it. She gets 4 a year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For a year.
[AGENT][NEUTRAL] And it pays $50.
[CUSTOMER][NEUTRAL] And the and the coke and it so it it her $50 and she gets 4 per year.
[AGENT][NEUTRAL] Per visit.
[AGENT][NEUTRAL] Yes I am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK and then did you say this was a PPO?
[AGENT][NEUTRAL] No, ma'am, it's not.
[CUSTOMER][NEUTRAL] It's not a PPO, um, OK, so it's just considered the she can go anywhere she wants to, OK, um.
[AGENT][NEUTRAL] She can go anywhere she wants to.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, and then I, I guess I just wanna make sure, um, I believe it's a multi plan right? that you know it's it's part of multi plan also.
[AGENT][NEUTRAL] Yes it is um and if you need to find out if you're a provider with multi plan I can transfer you over and you can give them your information and see if you're a provider with them.
[CUSTOMER][NEUTRAL] right
[CUSTOMER][NEUTRAL] Just the instructions on top.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um, I know we do multi plan. That's how I knew, uh, because like when it's, when they say like the American public life, it's like, uh, I don't know if we take that. Does it have anything else on your card?
[AGENT][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] OK, so $50.04 visits a year.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And so uh on an indemnity plan, it's just a set amount for a covered procedure and so the total visit will only pay $50.
[CUSTOMER][POSITIVE] OK, active and effective 3.
[CUSTOMER][NEUTRAL] A set amount
[CUSTOMER][NEUTRAL] For
[AGENT][NEUTRAL] Covered procedure.
[CUSTOMER][NEUTRAL] Covered procedure.
[CUSTOMER][NEUTRAL] That's what indemnity means indemnity means.
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Set amount for covered uh procedure.
[AGENT][NEUTRAL] So just the office visit itself will only pay $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, they only pay $50 OK, um.
[CUSTOMER][NEUTRAL] OK, so I guess if I could just please get a reference number from you and is that oh you [PII]? OK, OK, and today's date, OK.
[AGENT][POSITIVE] Absolutely you can use my name [PII] and today's date.
[AGENT][NEUTRAL] Yes, I'm a wife.
[CUSTOMER][POSITIVE] Uh, today is the [PII]. OK, [PII]. OK, thank you so very much. Mhm, it is Christi's Trinity Clinic.
[AGENT][NEUTRAL] And may I get the name of the facility?
[AGENT][NEUTRAL] Can I get the name of the business?
[AGENT][NEUTRAL] Christi Trinity Clinic.
[AGENT][POSITIVE] OK, thank you very much.
[CUSTOMER][NEUTRAL] Mhm in [PII], uh huh.
[AGENT][NEUTRAL] And your name was [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII]. OK. Thank you so much, Ms. [PII].
[CUSTOMER][POSITIVE] OK thank you you have a lovely day uh huh.
[AGENT][NEUTRAL] Is there
[AGENT][POSITIVE] You have a beautiful day too and thanks for calling APL.
[CUSTOMER][NEUTRAL] OK, uh huh bye bye.
[AGENT][NEUTRAL] Bye bye.