AccountId: 011433970860
ContactId: 74f05afe-fab7-4cc7-ac12-e854740e7776
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188199 ms
Total Talk Time (AGENT): 94681 ms
Total Talk Time (CUSTOMER): 85521 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/74f05afe-fab7-4cc7-ac12-e854740e7776_20250228T21:29_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from our provider's office. I just wanna check if we are in network with this plan.
[AGENT][NEUTRAL] [PII], I can help you with that work. I'm sorry, network information. What is the patient uh callback number?
[CUSTOMER][NEGATIVE] Shit.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII] and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] I don't have a policy number. Um, they just gave us the name of the insurance and they wanted us to um to check if we're network.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check with my either the MPI number of the doctor or tax ID to see?
[AGENT][NEUTRAL] It's gonna be determined by the policy number, but I would tell you Einia that none of our policies are major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, not, they're not medical.
[AGENT][NEUTRAL] Right, so even if there is a network participation, it's not well, it's not major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, are you calling for medical?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so our policies are not major medical insurance policies. So we have
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Limited indemnity policies and we had gap policies.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The limited indemnity policies may participate in a multi-plan network.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The network participation is not required.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So even if it does participate in a network.
[AGENT][NEUTRAL] We pay both in and out of network benefits.
[CUSTOMER][NEUTRAL] OK, OK, OK, so what type of insurance is this one? Just so I know for a future one.
[AGENT][NEUTRAL] Well, it just depends on the, the policy that the insured has.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They're taking my baby to the
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's just, you know, it's just gonna depend on the coverage, but um.
[CUSTOMER][NEUTRAL] OK, I got it.
[CUSTOMER][NEUTRAL] It depends what type of plan the the member has.
[AGENT][NEUTRAL] Exactly, and without the policy number, I would not be able to.
[AGENT][NEUTRAL] Give that specific information.
[CUSTOMER][NEUTRAL] OK, that's OK. I'll, I'll see if if I can get a hold of the patient who called to see if I can get that.
[AGENT][NEUTRAL] Did he get
[AGENT][NEUTRAL] Do you have a name? I mean, I can check my name or?
[CUSTOMER][NEGATIVE] No, no.
[AGENT][NEUTRAL] OK. All right, yeah.
[CUSTOMER][NEUTRAL] Because they somebody else called me to ask me and I didn't know but I was gonna call so I just look it up online and get the number but um I'm gonna see if I can if the patient gave their information to see if I can call them and get that and call back.
[AGENT][POSITIVE] All right. Yeah, and we'll be happy to um
[AGENT][NEUTRAL] You know,
[AGENT][NEUTRAL] Verify information or whatever.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We can provide.
[CUSTOMER][POSITIVE] OK, thank you so much for your help though.
[AGENT][POSITIVE] My pleasure, [PII], and thank you for calling APLA. I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.