AccountId: 011433970860
ContactId: 411d66d0-4aef-407b-8716-cdd59bf6983d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179039 ms
Total Talk Time (AGENT): 61024 ms
Total Talk Time (CUSTOMER): 64404 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/411d66d0-4aef-407b-8716-cdd59bf6983d_20250606T19:29_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Um, hi, I'm just calling to see, I'm a provider and the patient gave us phone numbers to try to get benefits for like a medical plan, just trying to see if we accept this insurance.
[AGENT][POSITIVE] I'd be happy to assist. May I have that policy number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, the ID number I have is, let's see here. Oh, actually he didn't.
[CUSTOMER][NEUTRAL] He didn't have that on, well, the number I have it may be [PII].
[AGENT][NEUTRAL] And patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And are you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This will be done in the doctor's office.
[AGENT][NEUTRAL] OK, so this is for an office visit, uh, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. The patient has um.
[AGENT][NEUTRAL] 6 visits per calendar year with the benefit amount of $75 per visit.
[CUSTOMER][NEUTRAL] So, um, like for this plan, do you all have a network or like who do we, um, you know, like send the claims to?
[AGENT][NEUTRAL] Um, you would send the claims, you can send the claims directly to our office.
[AGENT][NEUTRAL] And with this plan, um, the patient can see any provider that they choose. There's not necessarily any network. You can go anywhere. This is a limited benefit hospital plan.
[CUSTOMER][NEUTRAL] Yeah, I see.
[CUSTOMER][NEUTRAL] Yeah, see, we wouldn't take this, um, like I was trying to explain to him, the Kelty Sewell Clinic doesn't take that plan like that. It has to be like a network in order for them to get like the contracted rate.
[CUSTOMER][NEUTRAL] Um, is there like a claims address?
[AGENT][NEUTRAL] Um, the claims address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, no problem. Well thank you so much, that's all I needed.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Mhm