AccountId: 011433970860
ContactId: 1331cfa6-1be4-4777-ae4c-eea0deda01be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 391410 ms
Total Talk Time (AGENT): 143470 ms
Total Talk Time (CUSTOMER): 117531 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/1331cfa6-1be4-4777-ae4c-eea0deda01be_20250121T14:10_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][POSITIVE] Yes, hello, good morning, Miss [PII]. My name is [PII] with Benefits in a car. How are you today?
[AGENT][POSITIVE] I'm doing well, [PII]. How are you doing today?
[CUSTOMER][NEUTRAL] Good, thank you for asking um I was calling on behalf of a number that I have on hold. He's currently at the doctor's office and he was needing to get the group number and your fax number, but unfortunately we don't have access to that information. I was wondering if I can transfer you for you to provide him that.
[AGENT][POSITIVE] It would be my pleasure to transfer him. Do you have his social or his APL policy number so I can go ahead and pull him up.
[CUSTOMER][NEUTRAL] Yes ma'am, I have the policy number down as 251.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0922.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right, and you've already verified his information, correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. Everything we have on the system at the moment is current and it does show that we have not updated that recently, so it should match your records as well.
[AGENT][POSITIVE] Wonderful [PII], it was, and this is [PII] on the call, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] All right, I will be happy to help Mr. [PII]. Thank you, [PII], and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you too, Miss [PII]. Let me go ahead and get him transferred to you.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Good morning. My name is [PII] with APL. Is this Mr. [PII]?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, speaking.
[AGENT][NEUTRAL] Alright, I understand, uh, [PII] was telling me that you need some information on your policy.
[CUSTOMER][NEUTRAL] Yes ma'am, I just need your fax number.
[AGENT][NEUTRAL] Yeah, actually,
[CUSTOMER][NEUTRAL] At this point or the group ID.
[AGENT][NEUTRAL] OK, I can give you the group ID it is 70056.
[AGENT][NEUTRAL] And then the group name
[CUSTOMER][NEUTRAL] 70056
[AGENT][NEUTRAL] That's correct and if they ask for the group name, it's management analysis and utilization.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] Claims cannot be faxed, but I can give you the payer ID if they ask for that.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] That is 645-556.
[AGENT][NEUTRAL] That's it, yes, sir.
[CUSTOMER][NEUTRAL] OK, and you said claims.
[CUSTOMER][NEUTRAL] So they cannot be faxed, but they could be sent to what?
[AGENT][NEUTRAL] They can be um mailed to the [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty well I will give her the information once once she returns back to her her desk.
[AGENT][NEUTRAL] All right. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yes ma'am, uh, can I get an updated card with the group number on it to eliminate this process?
[AGENT][NEUTRAL] Let's see that
[AGENT][NEUTRAL] Is that group number not listed on the card? Let me take a quick look.
[CUSTOMER][NEUTRAL] No, ma'am, it's it's now listed on the card.
[AGENT][NEUTRAL] Bear with me just one second, let me check.
[AGENT][NEGATIVE] Yeah, unfortunately this is the only card we have available.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] The claims come
[CUSTOMER][NEUTRAL] To the to the PO box.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can I get the group number listed on the ID card.
[CUSTOMER][NEUTRAL] To remember that information there.
[CUSTOMER][NEUTRAL] We go through the same process every time I go seek out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you possibly tell me what my co-pay is for urgent care?
[AGENT][NEUTRAL] So there's no copay, deductible or co-insurance on this policy.
[AGENT][NEUTRAL] Your benefit amount that we pay is $75.
[AGENT][NEUTRAL] Per visit
[AGENT][NEUTRAL] Up to 5 visits per calendar year and that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, so for me to be saying today that's $0 in copay.
[AGENT][NEUTRAL] There is no co-pay or deductible on this plan.
[CUSTOMER][NEUTRAL] OK, so what does that mean?
[AGENT][POSITIVE] That means that that you don't have to pay toward a deductible copay or co-insurance. This policy will provide a benefit amount of $75 for your visit, and then you would be responsible for any remaining amount.
[CUSTOMER][NEUTRAL] OK, so I don't have, uh, to pay copay or deductible you said correct.
[AGENT][NEUTRAL] That's correct. We just provide the benefit amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty well thank you so much.
[AGENT][POSITIVE] It's been a pleasure to assist you and if the provider wants to give us a call, we'll be happy to verify your benefits.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Great, or deductible.
[AGENT][NEUTRAL] Or I can speak with her now if you'd like.
[CUSTOMER][NEUTRAL] She said she could speak to you.
[CUSTOMER][NEUTRAL] She said that's fine ma'am.
[AGENT][POSITIVE] Alright, well if we can be of further assistance, Mr. [PII], never hesitate to give us a call, and it has been a pleasure to assist you. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] Thank you bye bye.