AccountId: 011433970860
ContactId: 468fb3b9-a4e7-41d7-9376-1f6a66ffb713
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 399950 ms
Total Talk Time (AGENT): 141733 ms
Total Talk Time (CUSTOMER): 122217 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/468fb3b9-a4e7-41d7-9376-1f6a66ffb713_20250207T15:01_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes ma'am, my name is [PII]. I'm calling on behalf of Houston Methodist Primary Care. I just wanted to see if you can assist me on verifying benefits on a mutual patient.
[AGENT][NEUTRAL] OK, do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] And you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, policy number that was provided is 02574706.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment please.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Uh, first name is [PII]. Last name [PII]. Date of birth of the patient is uh [PII].
[AGENT][NEUTRAL] Thank you, [PII], and were you needing uh benefits?
[CUSTOMER][NEUTRAL] Uh, yeah, I just wanted to see if they have, uh, like any co-pays visiting their primary care doctor, see if there's copays, any deductibles out of pocket, and also if they have, uh, an annual physical available to them. Mhm.
[AGENT][NEUTRAL] OK, I can help you with that. Um, is this, this is for medical though?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Medical, yes ma'am mhm.
[AGENT][NEUTRAL] OK, this is a dental policy. Let me see if they have a medical policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The storage.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK, and you needed to know if an office visit was covered?
[CUSTOMER][NEUTRAL] Uh yes ma'am.
[AGENT][NEUTRAL] OK. The effective date is [PII]. Any benefits given over the phones, not a guarantee of payment.
[CUSTOMER][NEUTRAL] 21
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see if office visits covered. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. Actually, you have the dental department. Let me transfer you to that department to see if office visit is covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[AGENT][NEUTRAL] Hey [PII].
[CUSTOMER][NEUTRAL] Hey.
[AGENT][NEUTRAL] You answering the phone for a hospital indemnity?
[CUSTOMER][NEUTRAL] Well, hospital indemnity calls or come to the care team now.
[AGENT][NEUTRAL] Oh, really?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I don't know that.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So get someone, um, do you have a
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah, they were needing benefits and I'm not sure about this policy because I haven't even seen this policy. It's a HI 172.
[CUSTOMER][NEUTRAL] I think that's a newer policy. What's that policy number?
[AGENT][NEUTRAL] It is, it is 02574790.
[CUSTOMER][NEUTRAL] Lord, let me.
[CUSTOMER][NEUTRAL] 702.
[AGENT][NEUTRAL] And I, I'm trying to pull up the policy, but I can't see anything.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, it's like
[AGENT][NEUTRAL] And all I want to know if the office visits covered, but I'm not sure on this one.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Older ones I know, but this, this one I don't know.
[CUSTOMER][NEUTRAL] I don't see anything, but let me get one second I'm trying to see if I can pull up something.
[CUSTOMER][NEUTRAL] Yeah this is
[AGENT][NEUTRAL] Is there
[CUSTOMER][NEUTRAL] I know our policy.
[CUSTOMER][NEUTRAL] Please be in here, not the car policy certificate.
[AGENT][NEUTRAL] That's what I was looking to see. I didn't, I've seen a car.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Give me half a second. I've been looking in the group and see if I can find someone else that has a policy to where I can do TRPIQ.
[CUSTOMER][NEUTRAL] 717
[AGENT][NEUTRAL] I hated the transfer, but I don't know. I'm not gonna tell them wrong. I didn't.
[CUSTOMER][NEUTRAL] Oh no, I understand.
[AGENT][NEUTRAL] I didn't, um,
[AGENT][NEGATIVE] I tried to pull up the policy, but all I see is cards.
[CUSTOMER][NEUTRAL] Yeah, I just saw the card and it looks like this one's just a card too. Well, uh, you can't send it to me. I can try to help as much as I can.
[AGENT][NEUTRAL] Let
[AGENT][NEUTRAL] Hold on just a second. Call from Insured Part two for office visit benefits. Somebody had to call them back, so they didn't put it in the notes. I was trying to see if they put it in notes.
[AGENT][NEUTRAL] But they didn't put it in there. Yeah, I was trying to see if they put the benefit in a note, but they didn't give, put the benefit in and then they just said they called them back.
[CUSTOMER][NEUTRAL] But what, oh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Well, um, his name is [PII]. He's with the hospital.
[CUSTOMER][NEUTRAL] His name is [PII].
[AGENT][NEUTRAL] Uh-huh. It's a him.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] It's uh
[AGENT][NEUTRAL] His phone number is [PII].
[CUSTOMER][POSITIVE] All righty then.
[AGENT][NEUTRAL] And all he wants to know if the office visits covered.
[CUSTOMER][NEUTRAL] Just office visit. OK.
[AGENT][NEUTRAL] Uh-huh. OK. Thank you. Bye-bye.
[CUSTOMER][POSITIVE] Thank you, bye.