AccountId: 011433970860
ContactId: 855f539c-7cec-4eee-b239-52c77d1bbbde
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198460 ms
Total Talk Time (AGENT): 101409 ms
Total Talk Time (CUSTOMER): 64798 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/855f539c-7cec-4eee-b239-52c77d1bbbde_20250114T17:11_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling to um make sure we are in contract with the patient and that his insurance is active.
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility and network information, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 02582644.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] And his date of birth is, let me go back on [PII].
[AGENT][NEUTRAL] Perfect. Thank you. All right. OK, so we have an effective date of [PII]. It is active at the moment and this is one of our limited hospital indemnity plans. Uh, with this one, there is no network. If the provider participates with multi plan, they can get that additional discount but it's not required, so there's no network.
[CUSTOMER][NEUTRAL] Oh, OK, so he'd be a soft play patient. He doesn't have any medical coverage.
[CUSTOMER][NEUTRAL] Just emergency?
[AGENT][NEUTRAL] Uh, no, no, uh, this is a hospital indemnity plan. It does have benefits for office visits. Do you need the benefit information?
[CUSTOMER][NEUTRAL] Can I, well, when you say there's no
[CUSTOMER][NEUTRAL] No, um,
[CUSTOMER][NEUTRAL] How was that what do you use now?
[AGENT][NEUTRAL] Network.
[CUSTOMER][NEUTRAL] Network, what does that mean? Like, anybody is covered through them?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] It means that he can go to any uh doctor.
[AGENT][NEUTRAL] But he's not limited to go to certain doctors.
[CUSTOMER][NEUTRAL] OK, um, can you double, I mean, can you still double check that we're contracted with you guys though because I just wanna make sure.
[AGENT][NEUTRAL] Yeah, that's, that's what I'm trying to say that there's no con we have, we're not contracted with anybody, so there's no network at all.
[CUSTOMER][NEUTRAL] OK, so when we bill the insurance, it will get covered.
[AGENT][NEUTRAL] If you build the insurance, if it's a cover service, we'll go ahead and send the cover amount which is an indemnity, which is a flat amount like we pay flat amount depending because it's just a limited policy. This is not a major medical.
[CUSTOMER][NEUTRAL] Oh, OK, got it. OK, that makes sense now.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, can I have a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Sure. That's S as [PII], last initial [PII].
[CUSTOMER][POSITIVE] Thank you, so. Um, OK, that's all I needed. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Miss. [PII].
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you. Bye-bye.