AccountId: 011433970860
ContactId: 5c26271d-1d09-4cda-9151-72238f172790
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 304750 ms
Total Talk Time (AGENT): 77692 ms
Total Talk Time (CUSTOMER): 113386 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/5c26271d-1d09-4cda-9151-72238f172790_20250106T19:03_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII] at Cartersville Business office. How are you doing today?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm doing all right. I was calling to verify to see if we were in network, uh, for, uh, a patient of ours. They're trying to get a uh uh something scheduled with us.
[AGENT][POSITIVE] I'll be happy to assist with network information today [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Yes, callback number is going to be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Um, I think it's D as in Delta 43510808.
[AGENT][NEUTRAL] OK, I believe that is the wellness number. Do you have a social?
[CUSTOMER][NEUTRAL] Oh, the only other number she gave me was [PII].
[AGENT][NEUTRAL] OK, that might be what I can, you said [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have uh [PII], [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. Now I do show with this particular um policy uh there is no network they can see any provider they choose.
[CUSTOMER][NEUTRAL] OK, so you can see any provider they choose.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, um, perfect. What fee schedule do you all use?
[AGENT][NEUTRAL] Um, it's not a fee schedule. It this is a limited benefit hospital indemnity plan, so we only pay out a, a particular benefit amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, do you have a group number I can put in for this uh insurance?
[AGENT][NEUTRAL] Her group number? one moment.
[AGENT][NEUTRAL] 70055.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There is no um.
[CUSTOMER][POSITIVE] Fee schedule correct.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, hold on one second, I'm putting everything in right now.
[CUSTOMER][NEUTRAL] Uh, is there a maximum on this plan?
[CUSTOMER][NEUTRAL] And do, can you, can you tell us?
[AGENT][NEUTRAL] Right, this is a limited benefit hospital indemnity plan. So what type of services were you, was she getting?
[CUSTOMER][NEUTRAL] a lot of
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] today
[CUSTOMER][NEUTRAL] Um, the, she hasn't came in, come in just yet, um, uh, you know, we're trying to, we're trying to see if if we're in network for her.
[AGENT][NEUTRAL] Now, are you calling for medical or dental?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] That so.
[AGENT][NEUTRAL] Dental, oh, dental. I apologize, one moment.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] OK, so we go by UCR for the dental.
[CUSTOMER][POSITIVE] OK, UCR perfect.
[AGENT][NEUTRAL] And her benefit max is 500 per year.
[CUSTOMER][NEUTRAL] 500. OK, has she met that yet?
[AGENT][NEGATIVE] No, not this year, no.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And is it the same to to what you can go anywhere.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Alright, perfect.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Well thank you so much one question. What is her effective date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] When it's
[CUSTOMER][POSITIVE] Thank you thank you
[CUSTOMER][POSITIVE] Alright thank you so much I do appreciate it.
[AGENT][NEUTRAL] OK, was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Uh, that'll be it.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] I don't think I
[CUSTOMER][NEUTRAL] You too.