AccountId: 011433970860
ContactId: 67aa8394-6b3a-44c8-bbec-70ec1ce2d497
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216360 ms
Total Talk Time (AGENT): 98859 ms
Total Talk Time (CUSTOMER): 108541 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/67aa8394-6b3a-44c8-bbec-70ec1ce2d497_20250414T13:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, good morning. I'm here at Urgent Care trying to verify my benefits. Um, is there any way that you could pull up my account and verify with the medical staff here that I have $2500 in, uh, outpatient benefits including urgent care?
[AGENT][POSITIVE] Um, yes, ma'am. I can assist with benefits.
[CUSTOMER][NEUTRAL] OK, uh, you want my outpatient number?
[AGENT][NEUTRAL] Well, first, I'll need your name and a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Sure, yeah. [PII].
[CUSTOMER][NEUTRAL] [PII] 01887294 M as in Mary L as in Larry the number 8.
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need your policy number, please.
[CUSTOMER][NEUTRAL] Do you need the group number as well?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, no, I don't need the group number.
[CUSTOMER][NEUTRAL] 18,190.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see. Please verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK. Now, please verify your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. Just let me advise you that verification of coverage does not guarantee payment of claims. I'm showing the effective date on your policy was [PII]. Your policy is still active and for outpatient, including urgent care.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Last name [PII]. Mhm.
[CUSTOMER][NEUTRAL] Could you, could, could you verify it with, with the gentleman here for uh urgent care benefits? OK, thank you. Here you go.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] You can put it on speaker if you like. Hello?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yes, OK, uh, yes, uh, so the patient is here with their primary and their secondary, and the secondary is this number that she called you all, yeah, it's a supplement insurance.
[AGENT][NEUTRAL] Yes, sir, to supplement insurance and to verify outpatient benefits for urgent care, first, I'll need your name.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK. Thank you, [PII], and yes, just let me advise you that verification of coverage does not guarantee payment of claims. And for urgent care visits, we cover up to 4000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, alrighty, um, is there like a reference number or anything for for this phone call?
[AGENT][NEUTRAL] Yes, sir. For the reference number, you can use my name and today's date. Um my name is [PII]. It's spelled [PII] My last initial is [PII] and today's date. And also, do you need our information to submit the claim?
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] So you said uh the reference number is your name [PII]?
[AGENT][NEUTRAL] Yes, sir. And my last initial is [PII].
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] OK, and then, uh, today's date? OK, alrighty, and you said that her copay would be 0 for, for urgent care?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's correct, um, because we're 2nd, yes.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, alrighty then.
[CUSTOMER][NEUTRAL] And we'll make a note of it, OK?
[AGENT][POSITIVE] OK. Well, I thank you for calling APL. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] That's all thank you so much.
[AGENT][POSITIVE] OK. I thank you both for [PII].
[CUSTOMER][NEUTRAL] OK.