AccountId: 011433970860
ContactId: 47b31e12-df52-482e-adaa-6e5fbdf8d91a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251380 ms
Total Talk Time (AGENT): 112428 ms
Total Talk Time (CUSTOMER): 61250 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/47b31e12-df52-482e-adaa-6e5fbdf8d91a_20250516T15:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the Christ Hospital for um eligibility and benefits.
[AGENT][NEUTRAL] OK, well, I can help you with both the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02596148.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment, and I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Uh, for a primary care office visit.
[CUSTOMER][NEUTRAL] Um, and an urgent care, um, office visit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and [PII], is it OK if I place you on just a brief hold while I pull up the benefits?
[CUSTOMER][POSITIVE] Yeah, no problem.
[AGENT][NEUTRAL] All right, thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, actually it just popped up, never mind.
[AGENT][NEUTRAL] I'm just going to it now.
[AGENT][NEUTRAL] OK, so for both the primary care and the urgent care facility, it's the same benefit, um, which is $75 per visit with a max of 5 visits per calendar year. Um, this is a hospital indemnity policy, so it's a limited medical policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then is the facility reimbursed um for that benefit or does that go to the patient?
[AGENT][NEUTRAL] Um, it depends on how it's paid, um, you know, how it's sent in. If they've already paid, paid it, then we could reimburse them or it could go directly to you for, um, if it's billed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you OK and then what is the network uh for the plan?
[AGENT][NEUTRAL] Let me see if this one has one.
[AGENT][NEUTRAL] So the hospital indemnity part of the policy doesn't have a network, but the member does have the PPO network through multi-plan.
[CUSTOMER][NEUTRAL] OK, so she has the multi plan is that for the practitioner only and not the facility?
[CUSTOMER][NEUTRAL] Or is that for both?
[AGENT][NEUTRAL] No, it's for, it's for both, um, but I mean, if you wanted to get more about that part of the policy, I do have their phone number, um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then their website also, but
[AGENT][NEUTRAL] Whichever you prefer.
[CUSTOMER][NEUTRAL] You know this will be um the information I have is fine OK um is there a call reference?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, and what is your first name? I'm sorry?
[AGENT][NEUTRAL] It's OK. My name is [PII]
[CUSTOMER][POSITIVE] OK, thank you for your help.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Alright well thanks for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you, you're welcome bye bye.