AccountId: 011433970860
ContactId: 56363307-3be0-4479-9f89-b311f6d4ec3d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 151669 ms
Total Talk Time (AGENT): 78822 ms
Total Talk Time (CUSTOMER): 67222 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/56363307-3be0-4479-9f89-b311f6d4ec3d_20250620T14:30_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so I just, I had called a little while ago. This is from Essential walk-in clinic in primary care. Um, I, I, I forgot to ask that flat rate uh that pays for this member, um, is, can I know how what's that flat rate or can I get a, a fee schedule and somewhere so that we could know because this is the first time we're billing, um, I am APL.
[AGENT][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And we don't know what's the rate.
[AGENT][NEUTRAL] Yeah, I can go ahead and give you the information over the phone. We don't have a fax that we can send not for medical, but I can give you that information, Miss [PII]. OK, and we're still talking about legitimal?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Let me have just the date of birth just to make sure I'm reading the correct information.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you able to send it by email?
[AGENT][NEUTRAL] We cannot, we don't have a fax bag that we can send out for medical.
[CUSTOMER][NEUTRAL] Oh, OK, OK, got you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, OK, and let me go ahead and give you that benefit, and this is not a guarantee of payment, just a verification of coverage, Ms. [PII], and it looks like we cover $50 per visit, maximum of 4 visits per covered person per calendar year.
[CUSTOMER][NEUTRAL] $50 per visit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the max is 4.
[AGENT][NEUTRAL] 4 per year, for this per year. Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] For a year.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now $50 but that the insurance pays the patient does.
[CUSTOMER][NEUTRAL] The co-pay or coinsurances when they come into the office.
[AGENT][NEUTRAL] No, there's no co-payments, co-insurance or deductibles. This one is a flat amount. So that is what we're paying is $50 anything over members responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so anything over what? I'm sorry?
[AGENT][NEUTRAL] Anything over that amount is members responsibility unless they have another policy out there. We, we don't know if they have any other policies.
[CUSTOMER][POSITIVE] OK, alright, alright, so thank you so much for that information.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEGATIVE] No thank you. I promise I won't take and write this down, OK.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] It's OK. Well, thank you for calling APR. Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.