AccountId: 011433970860
ContactId: 88d8f1f8-3b01-41c7-8ce0-c62197adc7f1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172649 ms
Total Talk Time (AGENT): 86946 ms
Total Talk Time (CUSTOMER): 43355 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/88d8f1f8-3b01-41c7-8ce0-c62197adc7f1_20250108T19:37_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with Crum Family Healthcare, and I need to find out benefits and eligibility, please.
[AGENT][POSITIVE] OK, [PII]. I'm happy to check on benefits and eligibility for you. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Let's see, um, 02555798.
[AGENT][POSITIVE] Alright thank you so much let me pull this up.
[AGENT][NEUTRAL] And if I could get patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] OK, thank you for that. So, patient policy is active, [PII]. The effective date on this is [PII].
[CUSTOMER][NEUTRAL] And what is, I guess the insurance company is who?
[AGENT][NEUTRAL] Uh, so we are American Public Life Insurance.
[AGENT][NEUTRAL] The members plan type is a limited benefit medical plan, so it's what's called the hospital indemnity plan.
[AGENT][NEUTRAL] Uh, this just pays a set amount depending upon what the patient's being seen for.
[CUSTOMER][NEUTRAL] So she's here on a sick visit.
[AGENT][NEUTRAL] On an office visit, is that what you, OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right. So it looks like patient is allowed a total of 4 office visits per year.
[AGENT][NEUTRAL] And it looks like the plan is going to pay $50 towards the visit.
[CUSTOMER][NEUTRAL] $50.
[CUSTOMER][NEGATIVE] And none's been used this year.
[AGENT][NEUTRAL] I can double check for you here, one second, probably, probably not, but.
[AGENT][NEUTRAL] Uh, yeah, that is correct. I'm not showing anything used thus far.
[CUSTOMER][NEUTRAL] And so I guess it doesn't matter if they're in if we're in network or not network.
[AGENT][POSITIVE] Yeah, that's correct, yeah, not, not required for usage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and a call reference number?
[AGENT][NEUTRAL] Absolutely, [PII]. That's gonna be my name with my last initial and then today's date. My name again is [PII], that's spelled [PII] Last initial to my name is going to be [PII].
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.