AccountId: 011433970860
ContactId: 4b6165b0-ac51-4ddc-af89-24a082c3423e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357040 ms
Total Talk Time (AGENT): 131396 ms
Total Talk Time (CUSTOMER): 97889 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/4b6165b0-ac51-4ddc-af89-24a082c3423e_20250211T14:26_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Doctor [PII] office. Um, I'm calling for one of our mutual patient. Um, I was just trying to, uh, verify his insurance and make sure he's, um, eligible still.
[AGENT][NEUTRAL] OK, sure, I can assist you with eligibility. May I have your name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] [PII], and Miss [PII], can you repeat the name of the office that you're calling from? I didn't get the name.
[CUSTOMER][NEUTRAL] Of what again? I'm sorry.
[AGENT][NEUTRAL] Of the doctor.
[AGENT][NEUTRAL] Of the office [PII].
[CUSTOMER][NEUTRAL] Oh, Doctor [PII].
[CUSTOMER][NEUTRAL] Mhm. [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, um, [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Uh, policy number is 02587041.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Um, let's see, first name is [PII] and then last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. All right. You said you need eligibility. We have an effective date of [PII]. Um, it is showing active at the moment and this is one of our limited hospital indemnity plans.
[CUSTOMER][NEUTRAL] You say hospital and what?
[AGENT][NEUTRAL] A hospital indemnity plan?
[CUSTOMER][NEUTRAL] Hospital in
[CUSTOMER][NEUTRAL] OK, is it, uh, can he come see a primary care doctor?
[CUSTOMER][NEUTRAL] Like a family office.
[AGENT][NEUTRAL] Uh yes, yes, it does have benefits for office visits. Do you need the benefit information?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And for an office visit, we cover.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bear with me, I'm still waiting on the benefits.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] It's not giving me that part. Um, let me make sure this one does cover all.
[AGENT][NEUTRAL] I have to pull the paperwork. gonna be one more minute.
[CUSTOMER][NEUTRAL] You're fine.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK here we go.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] You know what, this one doesn't have any office visit coverage. No, this one is only for hospital admission, hospital consignment, surgery, and diagnostic testing.
[CUSTOMER][NEUTRAL] OK, it's only covered for um.
[CUSTOMER][NEUTRAL] You say surgery diagnostic.
[AGENT][NEUTRAL] Surgery, diagnostic testing and hospital confinement.
[CUSTOMER][NEUTRAL] Surgery, give me one second.
[CUSTOMER][NEUTRAL] Diagnostic and hospital confinement.
[CUSTOMER][NEUTRAL] Um, he wanna come in for a physical. Do, do you guys cover for that?
[AGENT][NEGATIVE] Not with this, this policy, no this one doesn't have any coverage for office at all.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Oh OK so it's just like mostly for hospital.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Alright, and can I get a.
[CUSTOMER][NEUTRAL] It's a confirmation number from from this.
[AGENT][NEUTRAL] Uh, we don't have reference numbers. You can use my name in today's date if you will. Um, do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, give me one second.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, that's S as in Sam, O as in Oscar, L as in [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] You say S [PII]?
[AGENT][NEUTRAL] Yes, mhm.
[AGENT][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK, and I'm put it today's date. Alright, thank you so much. I'll call the patient and let him know.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] No, that is it
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good day, Ms. [PII].
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you, bye bye.