AccountId: 011433970860
ContactId: ce34bf0c-5234-47a1-b868-0961f92069d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385040 ms
Total Talk Time (AGENT): 91130 ms
Total Talk Time (CUSTOMER): 148066 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/ce34bf0c-5234-47a1-b868-0961f92069d5_20250610T13:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII] with the initial [PII], calling to inquire on eligibility and benefits for a patient, please, who just provided this insurance.
[AGENT][POSITIVE] Sure, I can help you with eligibility and benefits for you. Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, direct line is [PII].
[AGENT][NEUTRAL] OK, and the policy number?
[CUSTOMER][NEUTRAL] OK, so on this card there's a policy or certificate number, then there's also a medical ID number, so I'll just provide that medical ID just to ensure that there are benefits or coverage. It is [PII].
[AGENT][NEUTRAL] It would be the policy certificate number.
[CUSTOMER][NEUTRAL] OK. 02633637.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just one moment while I look that up.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the patient's uh first and last name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yes, first name [PII], last name [PII] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, I'm showing that this policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And this is a hospital indemnity policy.
[CUSTOMER][NEUTRAL] Me.
[CUSTOMER][NEUTRAL] Hm, OK.
[CUSTOMER][NEUTRAL] So there, or I should say, is there any
[CUSTOMER][NEUTRAL] Medical coverage for PCP office visits?
[AGENT][NEUTRAL] Uh, I don't believe so, but let me go ahead and check. Yeah, let me go ahead and check.
[CUSTOMER][NEUTRAL] Being that it's a hospital.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][POSITIVE] God bless you.
[AGENT][NEUTRAL] And is this a wellness visit or is it for um an illness?
[CUSTOMER][NEUTRAL] So this let me make sure of that before last year um an office visit, a follow up visit from a.
[CUSTOMER][NEUTRAL] Previous sick visit last month.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's just a yeah PCP office sick visit.
[AGENT][NEUTRAL] OK, let me look.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I am seeing something, but I wanna go ahead and check it just in case so I don't give you the wrong information.
[CUSTOMER][POSITIVE] Sure, no worries, I appreciate it, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is just a verification of benefits, not a guarantee of payment. They do have an outpatient sickness benefit where we will pay, um, I believe it's up to $75 for an outpatient sickness visit. Um, it's only for a covered sickness in the physician's office, clinic, urgent care, or emergency room. Um, it won't cover the office visit though.
[AGENT][POSITIVE] But it will help cover the treatment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I see, OK.
[CUSTOMER][NEUTRAL] Got it. Are there any benefits for wellness or preventive checkups, the yearly checkups at a PCP office?
[AGENT][NEUTRAL] Not on this policy.
[CUSTOMER][NEUTRAL] I, I, I, OK, OK, that's what I need to be sure of, alrighty.
[CUSTOMER][POSITIVE] OK, [PII], I believe you have actually answered my questions there. I appreciate it. And um if you will, please, if allowed, provide the initial to your last name as well as a reference number for our conversation today.
[AGENT][NEUTRAL] Sure, so we don't have reference numbers, but you can use my name and last initial in today's date. So [PII] and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Easy enough.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] All right, [PII], well, I appreciate your time and your assistance, my dear. You are truly helpful. Thank you.
[AGENT][POSITIVE] Thank you for calling APL. If there's nothing else, I hope you have a great day.
[CUSTOMER][POSITIVE] Likewise sweetheart, take care bye bye.
[AGENT][NEUTRAL] Bye.