AccountId: 011433970860
ContactId: 862d16e0-658b-4321-81b4-d08367f6668f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226779 ms
Total Talk Time (AGENT): 87166 ms
Total Talk Time (CUSTOMER): 67864 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/862d16e0-658b-4321-81b4-d08367f6668f_20250122T18:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. Um, my name is [PII]. I'm a behavioral health provider, and I'm calling because I wanted to find out if I was in network with a client's plan.
[AGENT][NEUTRAL] OK, um, do you have a policy number, [PII]?
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] 02586264
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, give me one moment.
[AGENT][NEUTRAL] Verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yes, [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] Thank you [PII]. So you're wanting to know if you're contracted with the network of contracted providers such as multi plan?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, we do not have a list of their contracted providers, but I can give you their phone number and their website address.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, what is that number?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] believe that number as well as the uh web address is on the ID card as well.
[CUSTOMER][NEUTRAL] OK. Um, and would you be able to tell me if this policy has mental health services?
[AGENT][NEUTRAL] Uh, what is the what's the chief complaint?
[CUSTOMER][NEUTRAL] Um, as part of their benefits.
[CUSTOMER][NEUTRAL] Uh, anxiety, depression.
[AGENT][NEUTRAL] OK, so there is an office visit benefit under this policy which covers up to $75 per visit, a maximum of 5 visits per calendar year, that's per covered person, and then up to $10 for all combined persons. Um, I don't show any claims, um, and actually it's supposed to be an individual policy.
[AGENT][NEUTRAL] So the max is 5 visits per calendar year. She has 5 visits for.
[CUSTOMER][NEUTRAL] What does that mean?
[CUSTOMER][NEUTRAL] Oh, but meaning
[CUSTOMER][NEUTRAL] 05 is is per calendar year.
[AGENT][NEUTRAL] She's the only
[AGENT][NEUTRAL] And she's the only one that's on the policy giving you the family maximum as well, but she's the only one on the plan?
[CUSTOMER][NEUTRAL] Right. So then that would be only office visits.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And of course the information provided is verification, not a guarantee of payment until we get the actual document.
[AGENT][NEUTRAL] And did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, um, but I would just need to call that other number just to make sure that I am part of the network.
[AGENT][NEUTRAL] You know that's the PPO network that you'll be calling.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][POSITIVE] OK, great. Thank you so much.
[AGENT][POSITIVE] All right. Anything else I can help out with today?
[CUSTOMER][NEUTRAL] That would be all, thanks.
[AGENT][POSITIVE] All right, [PII], thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK, bye now.