AccountId: 011433970860
ContactId: bf7ddda4-4bad-4c2b-b996-60ddb2421e56
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236869 ms
Total Talk Time (AGENT): 90200 ms
Total Talk Time (CUSTOMER): 99589 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/bf7ddda4-4bad-4c2b-b996-60ddb2421e56_20250305T23:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] May I help you please? Hi, [PII]. My name is [PII]. I'm calling from Boulder Care Provider Group, and I have a patient's ID card here that I wanted to see if uh you guys could let me know if she is still effective today.
[AGENT][NEUTRAL] OK, I can check the eligibility of your patient Ms [PII], um, what is the callback number just in case our call is dropped I'll be able to call you right back.
[CUSTOMER][NEUTRAL] Sure. That is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK. It is [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] And policy number, is that the policy cert number?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, that is 02596736.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. Her effective date is [PII].
[CUSTOMER][NEUTRAL] OK. And do we bill with the policy number or the medical ID number?
[AGENT][NEUTRAL] The policy number.
[CUSTOMER][NEUTRAL] OK. And do we put that medical ID number in the group field or just don't worry about that number?
[AGENT][NEUTRAL] You shouldn't have to worry about it um because when we do the claims we do it by policy number.
[CUSTOMER][NEUTRAL] OK. And um are you able to see if this patient has a specialist in-network co-pay or co-insurance?
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] And this is just to verify the.
[AGENT][NEUTRAL] Benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So what she has is a limited benefit hospital indemnity plan.
[AGENT][NEUTRAL] And the indemnity plan is a set amount for a covered procedure, and she has physician office visits for accident or sickness, and it pays $50.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So she wouldn't have a co-pay, co-insurance or deductible with that type of plan.
[AGENT][NEUTRAL] No, ma'am. Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said that was um illness or accident coverage?
[AGENT][NEUTRAL] Yes, accident or sickness, and she gets 4 visits a year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um do you have a call reference number, [PII]?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Well, thank you very much for all of your time today.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I hope you have a good rest of your night, and we thank you so much for calling APL.
[CUSTOMER][POSITIVE] You as well. Thank you so much.
[AGENT][POSITIVE] You're welcome. Bye bye, ma'am.
[CUSTOMER][NEUTRAL] Bye-bye.