AccountId: 011433970860
ContactId: cc4de3de-ca45-4dd4-9fbe-6e48ca0b1574
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176339 ms
Total Talk Time (AGENT): 67300 ms
Total Talk Time (CUSTOMER): 76598 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/cc4de3de-ca45-4dd4-9fbe-6e48ca0b1574_20250613T19:04_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, how are you? I'm calling about a mutual patient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, because they have the APL with you guys and um they're saying that it covers their copay. Um, I've never seen a secondary cover the copay, so I'm just trying to see um what's going on or how it works.
[AGENT][POSITIVE] OK, I'll be happy to assist. And may I have your first name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And [PII], if I can get a good call back back for you.
[CUSTOMER][NEUTRAL] Uh, call back number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is that's what I'm confused about also hold on I'm pulling it up now.
[CUSTOMER][NEUTRAL] Uh, it says inpatient and we're a dermatology office, so I'll give you the outpatient, is that correct?
[AGENT][NEUTRAL] It doesn't matter which one.
[CUSTOMER][NEUTRAL] OK, 02300110 ML8.
[AGENT][NEUTRAL] patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, the name is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] Date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII].
[AGENT][NEUTRAL] And I do show um this policy actually has the um.
[AGENT][NEUTRAL] Physicians writer on it that would cover the co-pay um and you're a specialist visit, uh, so it would cover $50 of the co-pay and then they will cover 100. I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] $50?
[CUSTOMER][NEUTRAL] You said $50?
[AGENT][NEUTRAL] That's correct of the co-pay associated with the physician's charges and then 100% of any treatment that was done at the um at the office visit.
[CUSTOMER][NEUTRAL] OK, so I have they have a copay with their Aetna PPO $60 so I would charge them $10 then.
[AGENT][NEUTRAL] Right, because when you send us the claim, we're only gonna pay 50% of that of the physician's charges, but anything else is covered at 100%.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK perfect so I'll just charge them $10 and then we'll go from there. Perfect, thank you so much. I really do appreciate it.
[AGENT][NEUTRAL] Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Uh, no, that'll be it.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.
[CUSTOMER][NEUTRAL] You as well bye bye.