AccountId: 011433970860
ContactId: 1beb02be-d8db-478b-9a30-2fbc8a47cf26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202860 ms
Total Talk Time (AGENT): 79815 ms
Total Talk Time (CUSTOMER): 87557 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/1beb02be-d8db-478b-9a30-2fbc8a47cf26_20250424T19:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is [PII]. I'm calling from Laster Eye Center, and I would need to get uh benefits for a patient as far as uh deductible, co-insurance, and then a specialist co-pay, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, ma'am, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, it's D as in dog 445-04814.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits. That's gonna be our number.
[CUSTOMER][NEUTRAL] 02582808.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, it is [PII], last name [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you Miss [PII]. And what type of service is being rendered?
[CUSTOMER][NEUTRAL] And we are doing a medical eye exam. The patient is diabetic, and so I would just want to make sure that the patient has medical coverage, and that way I can build the correct plan um because I know she also has vision, but this is actually gonna go to her medical insurance.
[AGENT][NEUTRAL] Medical. OK. All right. Let me go ahead and give you the benefits, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our limited indemnity plans, so it is a limited plan. Um, with this one, let's see how much we cover.
[AGENT][NEUTRAL] office, OK. For the office visit specialist or PCP, we cover $150 per visit, maximum of 4 visits per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK. And so does the patient have a deductible or co-insurance or anything?
[AGENT][NEUTRAL] No, because this is an indemnity plan, it pays a flat amount. There's no co-payments, co-insurance or deductible because this is not a major medical unlimited plan.
[CUSTOMER][NEUTRAL] OK, got you, and then you only pay $150 just flat fee, that's it?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] Yes, OK, alright, well, perfect then I will go ahead and get that done now am I going to send this claim to the payer ID 64556?
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] Yes, OK, perfect, alrighty, well that is all I needed thank you so much for your help.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] You're welcome and thank you for calling APR. Have a good day, Miss [PII].
[CUSTOMER][POSITIVE] Alright you too thank you so much.
[AGENT][POSITIVE] Mhm. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye bye.