AccountId: 011433970860
ContactId: 33e809e4-303e-4596-95e1-890c49e9618f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300619 ms
Total Talk Time (AGENT): 112798 ms
Total Talk Time (CUSTOMER): 136411 ms
Interruptions: 4
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/33e809e4-303e-4596-95e1-890c49e9618f_20250424T18:28_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from a podiatry office. Um, I had a patient give me an APL card as a secondary card. I just wanted to verify that um the APL does pick up his copay. He has a $50 copay, so we just wanted to be sure.
[AGENT][NEUTRAL] OK, so you're wanting to verify eligibility and benefits for an office visit, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And who am I speaking with please?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] and I'm with To Podiatry.
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] That'll be.
[CUSTOMER][NEUTRAL] Outpatient hm group number payer ID it doesn't.
[AGENT][NEUTRAL] OK, you can give me the outpatient number. You can give me the outpatient number.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 355.
[CUSTOMER][NEUTRAL] 78 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK thank you give me a couple of moments please to get the member's information pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Can I give you an incomplete set of forms? I think I did. I can.
[CUSTOMER][NEUTRAL] in the page and I think it's because I.
[CUSTOMER][NEGATIVE] I think it's my fault.
[CUSTOMER][NEUTRAL] This one.
[CUSTOMER][NEUTRAL] Just do your name insurance.
[AGENT][NEUTRAL] OK, so any information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] And your date of birth, your pharmacy and your CD that would be very.
[AGENT][NEUTRAL] Hi, [PII], can you hear me?
[CUSTOMER][NEUTRAL] No, I
[CUSTOMER][NEUTRAL] Did you drop it on the floor maybe?
[AGENT][NEUTRAL] Hello, Airline.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, yeah, he does.
[CUSTOMER][NEUTRAL] Yes, with the $50.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, well, I'm, I'm trying, I'm trying to talk to the company.
[AGENT][NEUTRAL] Hi, are you still there, [PII]?
[CUSTOMER][POSITIVE] Yeah, are you still there? Thank you. Uh yes, I am. I am still here.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK, let me call you back.
[AGENT][NEUTRAL] Any information that I provide for you would be a.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Location of benefits and not a guarantee of payment. What is your?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] What is the patient's, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] His date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So he is the subscriber on the supplemental policy and the supplemental policy is active.
[AGENT][NEUTRAL] What's an effective date of [PII]?
[CUSTOMER][NEUTRAL] OK, so then how do we submit a claim?
[AGENT][NEUTRAL] OK, so are you needing benefits or no?
[CUSTOMER][POSITIVE] Beautiful, thank you.
[AGENT][NEUTRAL] You do or do not need benefits?
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] I guess I do. We've never seen this um policy or this card, so I'm, I'm just trying to figure out um where, how we would submit a claim, what, what we're doing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on the supplemental policy, office visits are not covered. However, he does have an office treatment rider, so if there's treatment rendered, that could be reviewed under his outpatient benefits.
[CUSTOMER][NEUTRAL] They to insurance.
[AGENT][NEUTRAL] And he has an outpatient
[AGENT][NEUTRAL] Patient benefit maximum of $700.
[CUSTOMER][NEUTRAL] You just went on mute. You're OK.
[AGENT][NEUTRAL] I'm not, no, ma'am, I'm not on mute. There's something wrong with the phone line.
[CUSTOMER][NEUTRAL] Right, I don't know if your, your phone.
[CUSTOMER][NEUTRAL] Just OK, I got you. Um, so what about his $50 copays? Do we submit a claim for that or is that not covered?
[AGENT][NEUTRAL] Office visit charges are not covered under this policy.
[CUSTOMER][POSITIVE] OK, OK, not covered under this OK, you've been a great help. I appreciate you have a great day.
[AGENT][NEUTRAL] We can review treatments.
[AGENT][POSITIVE] OK, yes, ma'am. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Oh I hope you have a beautiful day thank you.
[AGENT][POSITIVE] I hope you do too, and thank