AccountId: 011433970860
ContactId: 421f9574-e812-4dcd-89fa-56bcc50d3f42
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160270 ms
Total Talk Time (AGENT): 85233 ms
Total Talk Time (CUSTOMER): 62495 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/421f9574-e812-4dcd-89fa-56bcc50d3f42_20250117T23:30_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yes, I'm calling to try and verify um if this insurance is active for a patient who's trying to be seen here tonight.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with some eligibility real quick and do you mind if I get your name and a good callback number?
[CUSTOMER][NEUTRAL] [PII] [PII] I mean I'm sorry, that's my cell phone number.
[CUSTOMER][NEUTRAL] My name's my name's [PII], but the clinic's phone number is [PII].
[AGENT][NEUTRAL] Uh, it's OK.
[AGENT][POSITIVE] Perfect, thank you. And what's that member's policy number?
[CUSTOMER][NEUTRAL] It's 02469142.
[AGENT][NEUTRAL] Alright, give me a second to get that pulled up, Ms. [PII].
[AGENT][NEUTRAL] All righty. And would you be able to verify for me, please, your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alright, I do see [PII] right here. It looks like she is current and active with us. Um, her effective date is [PII].
[CUSTOMER][NEUTRAL] OK, does it say like what her copay is perhaps?
[AGENT][NEUTRAL] Oh, OK, yeah, so we're a secondary insurance. She's not gonna have a copay with us, but I can pull up some benefits for you. Are you needing inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Um, well, we're in urgent care, so I'm guessing outpatient, um, you said this is her second insurance, not her primary?
[AGENT][NEUTRAL] OK, I think.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, we're secondary, oh, yeah, we're secondary, so.
[CUSTOMER][NEUTRAL] Because she doesn't have any in her mom says she doesn't have any other insurance.
[AGENT][NEUTRAL] OK, so this is a limited supplemental hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so she does have, um, urgent care benefits. She can use up to once a year. It does look like it's a $75 benefit for accident or sickness.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and I do want to let you know any benefit information I give you over the phone is gonna be just a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so you said like a $75 copay?
[AGENT][NEUTRAL] It's not a copay. Her max benefit, like the most we will pay is $75.
[CUSTOMER][NEUTRAL] It's $75. OK, alright, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, my pleasure. Is there any other information you need today?
[CUSTOMER][NEUTRAL] No I appreciate oh what's your name just so I can have a reference number or something?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] You betcha it's [PII] and then the reference number is Ali B um in today's date.
[CUSTOMER][POSITIVE] OK thank you dear.
[AGENT][POSITIVE] Hey, my pleasure. Thank you for calling APL and you have such a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks bye bye.