AccountId: 011433970860
ContactId: 85909ef1-087d-426c-b0ab-ea9f67c52217
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269739 ms
Total Talk Time (AGENT): 101058 ms
Total Talk Time (CUSTOMER): 82413 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/85909ef1-087d-426c-b0ab-ea9f67c52217_20250310T18:39_UTC.wav
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[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, uh, my name is [PII]. I'm calling from, uh, Dominion Women's Health, and I'm actually calling to see if we are in network with you guys.
[AGENT][NEUTRAL] I can certainly look that up. [PII], what's the policy number, please?
[CUSTOMER][NEUTRAL] Oh shoot, for, uh, hold on, let me just one second, let me get that from my manager.
[AGENT][NEUTRAL] Sure, of course.
[CUSTOMER][POSITIVE] I'm stay running for me.
[CUSTOMER][POSITIVE] OK, thank you so much are you there?
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][POSITIVE] OK, alright, I got it now.
[CUSTOMER][NEUTRAL] Let me get her pulled up
[CUSTOMER][NEUTRAL] OK, so the policy number that we have for this patient is A like apple, F like Frank, L M like Mary F like Frank, E like elevator, A like apple 683,552,660.
[AGENT][POSITIVE] Thank you. And um is there uh uh if you don't mind uh spelling out their name for me, please? I'd really appreciate it.
[CUSTOMER][NEUTRAL] Yes, it's [PII] Last name is [PII]
[AGENT][NEUTRAL] OK, great. Thank you, and her date of birth, please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And, and the last thing, [PII], I just need a callback number in the event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So it looks like her policy number.
[AGENT][NEUTRAL] It's 255.
[AGENT][NEUTRAL] 43
[AGENT][NEUTRAL] 48. And you'd mentioned uh wanting to know about whether we're in network with you or not. Now, this is a secondary or gap insurance and so what we do is we pick up the deductible, co-payment or co-insurance from a major medical. So what you'd want to do is make sure that you are in network um with the provider.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And so there's got to be with the, with the major medical, yeah.
[CUSTOMER][NEUTRAL] OK, so, so this is, uh, this is not her primary. OK, do you have a record of what her primary is? This is the only because she only gave us to you guys, so.
[AGENT][NEUTRAL] This is not for primary.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Oh, really? OK, well, let's see what we've got. OK, so for [PII], what, um,
[AGENT][NEUTRAL] I think she's got asthma, but we'll just check.
[AGENT][NEUTRAL] OK, so what she has is AvMed, and I don't have anything else on that but that. But no, what we are is we're just this.
[CUSTOMER][NEUTRAL] Can you tell me what did you say that was?
[AGENT][POSITIVE] Uh Amed, [PII]
[AGENT][NEUTRAL] So she will need to provide you with that and you want to make sure that there's a deductible, co-payment or co-insurance. If nothing else, at least out of network benefits because that's what we pick up on these programs.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so you guys just cover deductible, co-insurance, co-pay?
[AGENT][NEUTRAL] That's right, yeah, but, um, but you always want to make sure that you're in network with the uh major medical.
[CUSTOMER][NEUTRAL] Primary, right, OK.
[AGENT][POSITIVE] Yes, exactly.
[CUSTOMER][NEUTRAL] OK, I will let them know we need some additional information.
[AGENT][NEUTRAL] Is there anything else at all I can help with, [PII]?
[CUSTOMER][POSITIVE] Uh, no, that's it. Thank you for your help.
[AGENT][POSITIVE] OK, thanks for contacting if you have