AccountId: 011433970860
ContactId: 375225d0-ad9b-4839-a797-f985849d717a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177720 ms
Total Talk Time (AGENT): 98284 ms
Total Talk Time (CUSTOMER): 70301 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/375225d0-ad9b-4839-a797-f985849d717a_20250313T18:13_UTC.wav
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[AGENT][NEUTRAL] for contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII] with Takapola Family Medical Clinic, and I may not have the right, um, connection, but I have a question. We have a patient who brought a
[CUSTOMER][NEUTRAL] Medical card in for like health insurance to us and I'm trying to verify eligibility.
[AGENT][POSITIVE] Yes, I could
[CUSTOMER][NEUTRAL] And see if it if we're even in network if he's got a copay or.
[AGENT][POSITIVE] I can certainly help with that [PII]. What, what's the policy number, please?
[CUSTOMER][NEUTRAL] All of the above.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] All I have is an employee ID.
[AGENT][NEUTRAL] Does it begin with a 01 or a 02? Does it, is it something like that or?
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] D404.
[AGENT][NEUTRAL] Oh, OK. Um, how do you spell the, the, uh, this man's last name?
[CUSTOMER][NEUTRAL] The last name [PII]
[AGENT][NEUTRAL] OK. And uh his first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And his date of birth, please.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] I appreciate that. Well, while I'm looking that up, so if I could have a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][POSITIVE] I do appreciate that. So let's see what we can find for [PII].
[AGENT][NEUTRAL] So he does have a medical policy with us.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That policy number is 02.
[AGENT][NEUTRAL] 59
[AGENT][NEUTRAL] 7840. So the card that he has, he, yeah, absolutely, yeah.
[CUSTOMER][NEUTRAL] I'm gonna repeat it OK?
[CUSTOMER][NEUTRAL] 02597840
[AGENT][NEUTRAL] Yes, that's correct. Now he does have a, this is a medical card, and what it does is that when you put back on [PII], it is active, and this is a limited benefit policy. So what that means is that it will pay a limited benefit for the coverage services. So for example, there are 4 office visits per calendar year. We will pay a maximum of $50 for each of those.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, if he goes to the ER, we'll pay a maximum of $50 for the ER visit. Um, if he, um, goes to the urgent care, we'd pay a maximum of $50 for it. And this is just a verification benefit, it's not a guarantee of payment, but it's just to give you an idea of the type of policy it is. It's not major medical. This is a limited benefit policy, um, but that is what this is for.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, alright, well I appreciate your time.
[AGENT][NEUTRAL] Is there anything else at all that I can tell you about this?
[CUSTOMER][NEUTRAL] I don't think so. What does it cover any type of lab work or injections or anything? OK.
[AGENT][NEGATIVE] Uh no, ma'am, it does not.
[AGENT][NEGATIVE] Uh, no, ma'am, it does not.
[CUSTOMER][POSITIVE] OK alright thank you so much.
[AGENT][POSITIVE] OK, well thank you for contacting if you have a good day.