AccountId: 011433970860
ContactId: 1a803ab1-dcb3-4979-a475-24717ba52aeb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195669 ms
Total Talk Time (AGENT): 85027 ms
Total Talk Time (CUSTOMER): 81141 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/1a803ab1-dcb3-4979-a475-24717ba52aeb_20250410T19:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm with Onic Region Health and Wellness here in [PII], and I just want to verify a patient is in network with us.
[AGENT][NEUTRAL] OK, sure. I can get that policy pulled up and see what network that's part of. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, I do. Policy number is going to be 02610663. The name of the individual is.
[CUSTOMER][NEUTRAL] [PII], last name [PII].
[CUSTOMER][NEUTRAL] The date of birth?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect thank you so much for verifying that, [PII]. OK, so this policy is active. Effective date was [PII] and so this is a limited indemnity medical plan so it is not affiliated with any set networks. Uh, it can be used potentially anywhere just pays a set dollar amount per covered procedure and or office visit you would just send that, uh, claim information directly to us.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so he does, it does cover, uh, mental uh as well because we're a mental facility.
[AGENT][NEUTRAL] Uh, let me double check that. Give me just a moment. What's, um, could you define a little bit more, more specifically what kind of mental health? Is this like a therapy facility?
[CUSTOMER][NEUTRAL] Mental health facility.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] No, we don't do therapy. Well, we do some therapy, but it's more for medication management and also, uh, any.
[CUSTOMER][NEUTRAL] Uh, you know, psychological or psych uh psychiatry or something like that, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Got you. OK, OK, give me just a moment, let me check those benefits.
[CUSTOMER][NEUTRAL] Mhm, OK.
[AGENT][NEUTRAL] OK, of course, I will let you know verification of coverage is not a guarantee of payment for claims. So there's no benefits for anything like mental health. Um, however, they do have a prescription drug benefit if that's what you meant, um, as far as
[CUSTOMER][NEUTRAL] Um-hum.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, no, no, I, no, we, we don't do, I mean, we prescribe the drugs, but we don't actually, we're not the pharmacy or anything like that, so we'd be the ones that would have to.
[AGENT][NEUTRAL] I see. OK, OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, there's not any mental health or even specialist uh visits on this policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, that's what I need to know thank you very much.
[AGENT][POSITIVE] Oh sure, of course. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] No, you've been more than helpful.
[AGENT][POSITIVE] All right, well, happy to help. Thank you for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too goodbye.
[AGENT][POSITIVE] Thank you. Bye-bye.