AccountId: 011433970860
ContactId: c4a96e55-b1ca-4594-9d46-6f4ae27212da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 351079 ms
Total Talk Time (AGENT): 144214 ms
Total Talk Time (CUSTOMER): 139626 ms
Interruptions: 7
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/c4a96e55-b1ca-4594-9d46-6f4ae27212da_20250501T20:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi, my name is [PII], and I'm calling from Access Medical Clinic in [PII], and, um, I have a patient, um, I'm not familiar with this insurance and I'm having a hard time verifying it and so I was gonna see if you could try and help me out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, I can help you with the insurance, the eligibility and the benefits for the patient. Miss [PII], what is your callback number? Just in case our call is disconnected.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And then can.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, her name is um [PII]
[CUSTOMER][NEUTRAL] Her date of birth is [PII]. I'm sorry, [PII].
[CUSTOMER][NEUTRAL] And you need the um you said the policy?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Is 0 is 02594990.
[AGENT][NEUTRAL] Oh let me look that up real quick.
[AGENT][NEUTRAL] Alright, I do show that [PII] does have an active policy with us. Um, the effective date of her policy is [PII].
[AGENT][NEUTRAL] And it's current.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. This is a limited um benefit hospital indemnity plan. So is she gonna be using it for outpatient or inpatient?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] We're, we're a, a medical clinic. We're an urgent care. We're not, yeah, she was just here for a doctor's visit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes ma'am. OK, so she does have 4 urgent care per calendar year that she can use and it pays $50.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] This is to verify the benefits. It's not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, is there any way that you can fax all of that information to me?
[AGENT][NEGATIVE] We don't have a way to do that um.
[AGENT][NEUTRAL] To fax the policy over to the provider, we don't have a way to do that.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] OK, so is this kind of like just like a discount program?
[CUSTOMER][NEUTRAL] I mean, I don't know.
[AGENT][NEUTRAL] No, it's actual hospital it's hospital indemnity plan which is, um, hospital indemnity plans are a set amount for a covered.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] She, she gets 4.
[CUSTOMER][NEGATIVE] You are cutting out really, really bad. I'm sorry.
[AGENT][POSITIVE] Oh, I'm sorry. I apologize.
[CUSTOMER][NEGATIVE] You're cutting out really, really bad.
[AGENT][NEUTRAL] Let me see if I can fix it.
[AGENT][NEUTRAL] Is that sound better?
[CUSTOMER][POSITIVE] Yes, very, yes, so much better.
[AGENT][POSITIVE] OK awesome yes thank you. I have to adjust this I anyway I fixed it. OK, so on, no, OK, OK.
[CUSTOMER][NEUTRAL] Oh, now it's starting to do it again but that's OK it's OK.
[AGENT][NEUTRAL] So for outpatient, she has 4 urgent care office visits per year that pay $50.
[CUSTOMER][NEUTRAL] She only has 4.
[AGENT][NEUTRAL] Yes, it's a limited benefit indemnity plan.
[CUSTOMER][NEUTRAL] 4.
[CUSTOMER][NEUTRAL] Per 4 visits per year.
[CUSTOMER][NEGATIVE] 4 visits per year and they and it only pays $60.
[CUSTOMER][NEUTRAL] For the office visit? 50.
[AGENT][NEUTRAL] 5050.
[AGENT][NEUTRAL] Yes, 50.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, um.
[AGENT][NEUTRAL] And that's, um, that's a set amount.
[CUSTOMER][NEUTRAL] OK, so she doesn't have like a set copay then, OK.
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, well, um, thank you for your help and I will let her know about about the 4 visits.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right thank you.
[AGENT][POSITIVE] Yes ma'am, you're very welcome.
[CUSTOMER][NEUTRAL] Uh-huh, right.
[AGENT][POSITIVE] Alright well you take care and thanks for calling APL, Miss [PII].
[CUSTOMER][POSITIVE] Thank you uh huh bye bye.
[AGENT][NEUTRAL] Bye bye.