AccountId: 011433970860
ContactId: 3b8f1a59-e27c-463e-ad2b-dc9d7188d4db
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197720 ms
Total Talk Time (AGENT): 108100 ms
Total Talk Time (CUSTOMER): 53290 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/3b8f1a59-e27c-463e-ad2b-dc9d7188d4db_20250103T14:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good morning. I was calling to get eligibility and benefits, please.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, it is [PII] and the callback number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] 2550107
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII], and the policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Um, yes, ma'am. I actually just needed to see if they had any co-pays for a PCP specialist or urgent care visit, please.
[AGENT][NEUTRAL] Um, no, ma'am. Under this plan, there's no co-pays. Um, this is a limited hospital indemnity plan, but we do cover some outpatient services, and for outpatient visits, we cover up to $4 per calendar year, and we cover up to $50 per visit. And again, there's no co-pay.
[CUSTOMER][POSITIVE] Perfect. Thank you. Um, may I have the group number if there is one?
[AGENT][NEUTRAL] Um, yes, the group number is.
[AGENT][NEUTRAL] 70075.
[CUSTOMER][NEUTRAL] And then just the claims address and payer ID please.
[AGENT][NEUTRAL] OK. The pair ID is 60801.
[AGENT][NEUTRAL] Well, I'm sorry, actually for this policy, there is a different pair ID. Um, the pair ID for this policy is 64556.
[CUSTOMER][NEUTRAL] OK, that was 645-556?
[AGENT][NEUTRAL] Yes, ma'am. That's the correct pair ID.
[CUSTOMER][NEUTRAL] OK perfect and the claim address?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, the address to mail claims is IMA.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and [PII] is spelled [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Great and then one more question um do they utilize a network or do they not have one with their plan?
[AGENT][NEUTRAL] Right, there's no network.
[CUSTOMER][POSITIVE] OK, thank you so much. Can I get your name and a reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII] um it's spelled [PII] is [PII] and today's date. Um, is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, ma'am. I appreciate all your help and I hope you have a great weekend.
[AGENT][NEUTRAL] You do the same, Summer. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Bye. Bye-bye.