AccountId: 011433970860
ContactId: c6755cef-a9f9-4005-a554-4656f2ef5c6b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222369 ms
Total Talk Time (AGENT): 124714 ms
Total Talk Time (CUSTOMER): 54649 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/c6755cef-a9f9-4005-a554-4656f2ef5c6b_20250109T14:07_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Morning, Ms. [PII]. This is [PII] calling from Community Health Network. I have a patient. Um, I need to see if she's active.
[AGENT][POSITIVE] OK, and I'm so sorry. Did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], and you're just needing to verify if the member's policy is active. You do not need benefit information, is that correct?
[CUSTOMER][NEUTRAL] I'm gonna need both, hon.
[AGENT][POSITIVE] OK, so yes, I can help you with those things. So first off, [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 02484218.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], and then the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So she is the subscriber on this limited benefit plan and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK. And then can I get um her visits, and is she still only have 4 visits per year?
[AGENT][NEUTRAL] Uh, give me just one moment to get that benefit information pulled up, please.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is for an office visit, is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So yes, ma'am. And again, any information provided would be a verification of benefits and not a guarantee of payment. But yes, ma'am, on her policy for outpatient accident and sickness, a physician's office visit benefit, that's $100 per day, max of 4 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And has she used any of them?
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] Yes. Probably not, but it's good to ask.
[AGENT][NEUTRAL] I'm not.
[AGENT][NEUTRAL] Absolutely, just one moment. Now, ma'am, as of now, she has not.
[CUSTOMER][NEUTRAL] All right. And your name was?
[AGENT][NEUTRAL] [PII], and you will use my name along with today's date as your call reference number.
[CUSTOMER][POSITIVE] All right. Thank you, Ms. [PII].
[AGENT][NEUTRAL] All right, well, you're very welcome, [PII]. So if that's all I can help you with, thank you again for calling APL. I, one more thing, uh, you may already be familiar with this and you may already have it, but we do have a website that once we process the claim, you should be able to check claim status and have access to the explanation of benefits.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] And that website is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] All right. Thank you, Ms. [PII].
[AGENT][POSITIVE] All right. Well, you are certainly welcome, [PII], and I hope you have a wonderful day and thank you again for calling APL.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.