AccountId: 011433970860
ContactId: 6900c005-e6c0-4052-bfdf-57a8a6bf174a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352230 ms
Total Talk Time (AGENT): 122477 ms
Total Talk Time (CUSTOMER): 59572 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/6900c005-e6c0-4052-bfdf-57a8a6bf174a_20250418T13:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi, I'm just looking to verify some insurance today.
[CUSTOMER][NEUTRAL] Alright, verify someone's um multi plan.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Verify benefits.
[CUSTOMER][NEUTRAL] Um, do you need
[CUSTOMER][NEUTRAL] Yes, the eligibility.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have the policy number?
[CUSTOMER][POSITIVE] Yes I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's gonna be 02.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 55
[CUSTOMER][NEUTRAL] 1202.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, and then what's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Absolutely it's gonna be [PII]. I'm calling from a provider's office.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, and then whom am I speaking to?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right. And then what's the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is gonna be [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, so it looks like this policy is active and the effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then did you wanna check benefits as well?
[CUSTOMER][NEUTRAL] Yes, this is our urgent care facility, so I need to know how much their copay is.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, just one minute. Let me look deeper into their policy really quick.
[CUSTOMER][POSITIVE] OK, not a problem.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so this is not a guarantee of payment, just a verification of coverage. So it looks like co-pays are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, do they have a deductible plan?
[AGENT][NEUTRAL] They do not. This is a hospital indemnity plan. So it's for accident and sickness, um.
[AGENT][NEUTRAL] Let's see.
[AGENT][POSITIVE] They do have a diagnostic testing benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like that is 100 per day, maximum of 2 days per calendar year per covered person. So if they were getting tested, testing done in the office.
[AGENT][NEUTRAL] Uh, that's the only benefit I see that would.
[AGENT][NEUTRAL] Cover urgent care.
[CUSTOMER][NEUTRAL] And you said that was $100?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yeah, for the most part, their plan is, uh, for like hospital admission.
[AGENT][NEUTRAL] So since this is an urgent care.
[AGENT][NEUTRAL] I don't really fall under that.
[CUSTOMER][NEUTRAL] OK, so, um, you said their plan is mostly like for hospital visits?
[AGENT][NEUTRAL] Yes, it's a hospital indemnity plan.
[AGENT][NEUTRAL] So it's mostly for accidents. Um, we're just a secondary policy to their primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I figured you guys were supplemental.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I mean you can always submit a claim with us and see if it's covered, but.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] From what I'm seeing, it's.
[AGENT][NEUTRAL] It's just hospital.
[CUSTOMER][NEUTRAL] So it won't be covered with you guys, right?
[AGENT][NEUTRAL] No. Mm mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, not at this time you've been wonderful.
[AGENT][POSITIVE] OK. Oh, thank you. All right. Well, thanks for calling APL and I hope you have a good day, [PII].
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] All right. Bye.