AccountId: 011433970860
ContactId: 5b2aaed6-fb2e-4fd8-8f9c-27f4c14c545f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 133460 ms
Total Talk Time (AGENT): 60907 ms
Total Talk Time (CUSTOMER): 59710 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/5b2aaed6-fb2e-4fd8-8f9c-27f4c14c545f_20250324T18:08_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, yes, um, [PII]. My name is [PII] with Foothills Community Healthcare, and I wanted to check to see if, uh, this patient's insurance is a medical insurance for daughter's office visits.
[AGENT][NEUTRAL] Sure, I can assist you with that. You said your name was?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, [PII] I M. Last name is [PII].
[AGENT][NEUTRAL] [PII], can I have a callback number for you just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII] and [PII] [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number of the member that you're inquiring eligibility for?
[CUSTOMER][NEUTRAL] OK, 026-06738.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII] Date of birth [PII].
[AGENT][NEUTRAL] Thank you, [PII]. This policy is a gap insurance which assists with deductible, co-pay and co-insurance to the primary insurance.
[CUSTOMER][NEGATIVE] Oh, because I don't see that he has a primary. He didn't give us that.
[AGENT][NEUTRAL] Well, this is definitely not his primary. This is a gap insurance. And what's the place of service?
[CUSTOMER][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] Um, Foothills Community Healthcare, and he's in, um, like it's a PCP office.
[AGENT][NEUTRAL] So it's the office, so the treatment received in the office is not covered under the policy.
[AGENT][NEUTRAL] But the, um, I'm sorry, the office visit is not covered under the policy, but the treatment received in the office is covered under the policy and it falls under the outpatient benefits.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Of $2000 per calendar year and this is not a guarantee of benefits just a disclaimer of the policy coverage.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, wonderful. Well, thank you very much for your help.
[AGENT][POSITIVE] You're welcome [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] That's it. I hope you have a great day.
[AGENT][POSITIVE] Thanks for calling APA. You have a great one as well, [PII].
[CUSTOMER][POSITIVE] OK thank you alright bye bye.
[AGENT][POSITIVE] You're welcome bye.