AccountId: 011433970860
ContactId: 961aa245-028e-42af-96ad-3d7d972c002d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190039 ms
Total Talk Time (AGENT): 105278 ms
Total Talk Time (CUSTOMER): 69162 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/961aa245-028e-42af-96ad-3d7d972c002d_20250205T16:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, I'm sorry, what is your name? [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh thank you. OK, I'm calling in reference to a mutual patient. I wanna check eligibility please.
[AGENT][NEUTRAL] Sure, I can check eligibility for you. Um, I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] I have um 02585505.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Is [PII] [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that [PII]. Uh, so this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and if I'm not mistaken, it's it's it's got like 5 visits are covered for the whole year.
[CUSTOMER][NEUTRAL] Let me see, I put a um.
[AGENT][NEUTRAL] I believe so that is this kind of plan, um, this is a limited indemnity medical plan.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bear with me just a moment. That is typically how they work, but let me verify.
[CUSTOMER][NEUTRAL] Do they pay, um, is there a copay on this insurance?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, um, as this is a limited indemnity plan, uh, there is no co-pay, deductible, anything like that. Um, it is a bit limited on its coverage, of course, um, and it pays a set dollar amount per procedure or office visit. Let me verify that. Give me just a moment.
[CUSTOMER][NEUTRAL] Of $75 right? Yeah.
[CUSTOMER][NEUTRAL] Do you pay telemed visits? Do you pay for telemed visits?
[AGENT][NEGATIVE] I don't believe this one does, um.
[AGENT][POSITIVE] Give me just a moment. I'm getting the benefits pulled up here. Let's see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, of course I will let you know verification of coverage is not a guarantee of payment for claims. Uh, so yes, you're correct about the $75 maximum visits uh $5 per calendar year. Um, I know it's only been about a month, but I can still just go ahead and double check to see if any of that has been used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bear with me just a moment. OK, so he's not used anything so far this year.
[CUSTOMER][NEUTRAL] OK, and could you check about the telemed visits for me?
[AGENT][NEUTRAL] Yes, let's see.
[AGENT][NEUTRAL] OK, no, that's not going to be a covered benefit under this policy.
[CUSTOMER][NEGATIVE] They're not covered.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, may I have a reference number, [PII]?
[AGENT][NEUTRAL] Sure, it would just be my first name, last and middle and today's date. Uh, so my last initial is [PII] Uh, was there anything else I could help you with today?
[CUSTOMER][NEUTRAL] No, that's it. I just wanted to, uh, verify it, um, and today's date you said so it's what, [PII] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, thanks very much. I appreciate it.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] You too thanks.
[AGENT][POSITIVE] Thank you, bye bye