AccountId: 011433970860
ContactId: c8b2f451-3ddc-4717-8589-f42f954b860a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283359 ms
Total Talk Time (AGENT): 108461 ms
Total Talk Time (CUSTOMER): 109433 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/c8b2f451-3ddc-4717-8589-f42f954b860a_20250429T13:40_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, I'm [PII]. I'm calling from Total MD. I'm calling you because we have a patient here with, uh, APL insurance, and we want to get, uh, benefits and eligibility for him, please.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yes, of course it's gonna be [PII].
[CUSTOMER][NEUTRAL] I'm sorry, [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] Policy number 13.
[CUSTOMER][NEUTRAL] I think it's 025077709 ML 8.
[CUSTOMER][POSITIVE] No, I think that's it. I appreciate your help.
[AGENT][NEUTRAL] Can you please verify the patient's.
[CUSTOMER][NEUTRAL] And if you need the grow
[CUSTOMER][NEUTRAL] Oh, you need the group number or is it not required?
[AGENT][NEUTRAL] We'll verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII], last name [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. One moment, please.
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Wait, what is your email?
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] Car insurance, and do you have health insurance?
[CUSTOMER][NEUTRAL] Any claim numbers
[CUSTOMER][NEUTRAL] Do you have a phone? Yes, go ahead and sign your license.
[CUSTOMER][NEUTRAL] What's your name, ma'am? [PII].
[AGENT][NEUTRAL] Uh yes, sir. I found them in our system. Um, just let me advise you that verification of coverage does not guarantee payment of claims.
[CUSTOMER][NEUTRAL] Project in if you can
[AGENT][NEUTRAL] And let me give you his policy number.
[CUSTOMER][NEUTRAL] OK, go ahead please
[AGENT][NEUTRAL] His policy number is 025.
[AGENT][NEUTRAL] 07709.
[CUSTOMER][NEUTRAL] All
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on the policy was [PII]. The policy is still active and is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] For office visit, yes.
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to $500 per day and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yes, because he has a Florida blue and.
[CUSTOMER][NEUTRAL] In the copayment he has $20 for office visit.
[AGENT][NEUTRAL] Writing
[AGENT][NEUTRAL] OK. Yes, sir. And as his secondary insurance, we won't cover the copay, but any other services that goes towards the
[CUSTOMER][NEUTRAL] You guys cover the copay?
[AGENT][NEUTRAL] No, sir, we don't. We only cover the charges that goes towards the co-insurance and the deductible. We'll cover up to $500.
[CUSTOMER][NEUTRAL] Oh, only for coinsurance and deductible, OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And you said it's active since [PII] last year?
[AGENT][NEUTRAL] Um, let's see. Let me make sure.
[AGENT][NEUTRAL] Yes, [PII] of last year of [PII] and the policy is still active.
[CUSTOMER][POSITIVE] Still active OK.
[CUSTOMER][NEUTRAL] And the health insurance
[CUSTOMER][POSITIVE] Alright perfect
[CUSTOMER][NEUTRAL] Can I get a confirmation number please?
[AGENT][NEUTRAL] Um, yes, for the confirmation number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] This
[CUSTOMER][POSITIVE] No, that's gonna be all for now thank you so much for your help I really appreciate it.
[AGENT][POSITIVE] Yeah, thank you, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] Thank you, love you too thank you bye bye.
[AGENT][POSITIVE] Mm, thank