AccountId: 011433970860
ContactId: 1bc74289-3757-4b91-8e33-9f711c2f2ab9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258140 ms
Total Talk Time (AGENT): 90913 ms
Total Talk Time (CUSTOMER): 145114 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/1bc74289-3757-4b91-8e33-9f711c2f2ab9_20250107T19:36_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], how are you doing?
[AGENT][NEUTRAL] Fine, how are you?
[CUSTOMER][POSITIVE] I'm great thanks for asking [PII]. I have a provider on the phone by the name of [PII]. He's calling to verify benefits.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] It's 257-6376. It's 257-6376 for [PII].
[AGENT][NEUTRAL] OK, and I just need to verify benefits.
[CUSTOMER][NEUTRAL] Mhm, he's verified all of her information and the callback number is [PII]. His name is [PII].
[AGENT][NEUTRAL] OK. You can send it to me.
[CUSTOMER][POSITIVE] Thank you. Alright, let me transfer him over.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Hello [PII], I'm gonna transfer you to [PII] so she can better assist you with the medical benefits. Thanks for calling APL and have a great day. Goodbye.
[AGENT][NEUTRAL] Hi [PII], this is [PII].
[CUSTOMER][NEUTRAL] Hi [PII], um, sorry about that. I apparently was, uh, rather to dental, uh, so for medical benefits, um, so yes, my name is [PII] calling from Genentech Aive Solutions. I'm calling to request to the doctor and on behalf of the patient. I know that may be recorded for quality and training purposes, um, and, uh, I'm trying to verify eligibility and benefits for a drug infusion, but it may not be covered.
[AGENT][NEUTRAL] OK. I can help you with that, [PII]. I show that she has a limited hospital indemnity plan. I do show it's currently active, effective 1216, or 24. Under this policy, it covers limited benefits. Are these drug infusions performed in a physician's office or hospital? OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] This is gonna be, uh, so let's see actually let me double check which, uh, it's gonna be inside of the office.
[AGENT][NEUTRAL] OK, so the policy does cover a limited benefit for accident sickness in the physician's office. It covers a limited benefit of $50 per visit. She gets a max of 4 visits per calendar year, and I just must advise that this is just a verification of coverage and benefits. It does not guarantee payment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so $50 per visit up to 4 times a year and it runs on a year, right?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, for the office visit benefit.
[CUSTOMER][NEUTRAL] OK. Um, so I just wanna double check, um, the Shat gave me a dental ID which I believe is probably not gonna be working for the medical, right? Not the same. Um, I was given a
[AGENT][NEUTRAL] They're not the same. I can give you the policy number.
[CUSTOMER][NEUTRAL] Uh, policy number that I have was received from the patient was 02576376, and this should be for patient.
[AGENT][NEUTRAL] Yes, that would be for the medical.
[CUSTOMER][POSITIVE] Perfect thank you so much for that.
[CUSTOMER][NEUTRAL] OK, um, alright, now let's see here. Hospital identity, uh, are there any group numbers or group names associated with the plan?
[AGENT][NEUTRAL] Yes, I can give that to you. The group number is 70055.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the name of the group is TRC Staffing Services Inc.
[CUSTOMER][NEUTRAL] Versus in, uh, could you, uh, spell out the first three letters?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, T as in Tom, R as in Robert, C as in cat.
[CUSTOMER][NEUTRAL] Perfect. TRC as I also have written it down, um, [PII] did say the dental plan started [PII] of last year or [PII]. Is that the same for the uh for the medical?
[AGENT][NEUTRAL] Yes, the same effective date is [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, so this is just limited. OK, then just that $50 per year. OK, um, with that, I don't suppose I'm guessing referrals and authorizations are probably not gonna be a thing under this plan.
[AGENT][POSITIVE] Correct, since it's not a major medical plan.
[CUSTOMER][POSITIVE] Perfect, perfect. Alright, thank you so much for that, [PII]. That's all I need to confirm for today. Could I get your last name initial and a call reference if you have one?
[AGENT][NEUTRAL] Sure, it's [PII], and it, it'd be just my name in today's date and my first name is spelled [PII] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no, that will be all. Thank you for asking. I appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome thanks for calling APO you have a good day.
[CUSTOMER][POSITIVE] Take care.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][POSITIVE] Thanks, bye