AccountId: 011433970860
ContactId: 8f8df1b5-7448-4597-8d14-62b70cac2966
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217080 ms
Total Talk Time (AGENT): 90168 ms
Total Talk Time (CUSTOMER): 104740 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/8f8df1b5-7448-4597-8d14-62b70cac2966_20250123T21:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. I'm calling from urgent care at the point, and I have a patient here that has your insurance. Um, we are in urgent care, so we spoke with someone earlier to let us know which insurance to use for him being an urgent care, but we don't, we can't verify to know his benefits or what his co-pay or deductible is.
[AGENT][POSITIVE] OK, I can help you with your name.
[CUSTOMER][NEUTRAL] OK, the patient's name. Oh, well, I'm sorry, my name or the patient. My name is [PII], that's [PII]
[AGENT][NEUTRAL] Your name?
[AGENT][NEUTRAL] OK, and what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] OK, the policy number is 02571252.
[AGENT][POSITIVE] Thank you. And a good phone.
[CUSTOMER][NEUTRAL] And we didn't know if we should go, we didn't know if we should go by the policy slash cert number or the medical ID number.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] The patient's name is [PII].
[CUSTOMER][NEUTRAL] And the patient's date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. The policy effective date is [PII]. Um, I show this policy is active at this time. And did you say earlier that you called for benefits?
[CUSTOMER][NEUTRAL] Well, he didn't have a, um, no, we didn't for benefits, we call for the actual card because he didn't have proof of the insurance. Yeah, so they didn't give us the benefit information.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK. And you said this is for an urgent care visit?
[CUSTOMER][NEUTRAL] Yes, we are urgent care.
[AGENT][NEUTRAL] OK, so under this policy, um, it's a limited hospital indemnity policy and the urgent care benefit is up to $50 per day.
[AGENT][NEUTRAL] And then there's a maximum of 4 visits.
[AGENT][NEUTRAL] Her calendar year.
[AGENT][NEUTRAL] And information provided is verification only, not a guarantee of payment. I don't show that any that he's had an urgent care visit this year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So this will be the [PII].
[AGENT][NEUTRAL] At this time?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and it's a $50 copay per day?
[AGENT][NEUTRAL] Uh, it's not a copay. It's the benefit that his policy covers, so it's 50, it, it'll go towards the total bill amount.
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][POSITIVE] That's a benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and does he have a copay or anything?
[AGENT][NEUTRAL] Uh, we can just basically quote you what his benefit covers, so it covers up to $50 of the, the bill amount.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then you know we don't state what the patient owes or if they're, you know, subject to paying a copay or not that's up to the provider's office.
[CUSTOMER][NEUTRAL] OK, I got you, but you're, it, it only allows $50 and that's it.
[AGENT][POSITIVE] Per day, correct.
[CUSTOMER][NEUTRAL] OK. So do, so do we have a deductible for that or that, that's just it?
[AGENT][NEUTRAL] Yeah, there is no deductible co-insurance under this policy. It just pays a flat benefit of up to $50 per day.
[CUSTOMER][NEUTRAL] OK, no deductible or co-insurance. Alright, thank you, ma'am. That's all I need.
[AGENT][POSITIVE] All right. If no other questions, Alhey, thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You're welcome. Thank you. Bye-bye