AccountId: 011433970860
ContactId: cfced992-e00b-4a0e-95b5-17e79a43fb49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226740 ms
Total Talk Time (AGENT): 87156 ms
Total Talk Time (CUSTOMER): 78901 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/cfced992-e00b-4a0e-95b5-17e79a43fb49_20250514T19:40_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hello [PII]. My name is [PII]. I'm calling for a Florida provider and I'm checking benefits.
[AGENT][POSITIVE] OK, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Direct line [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Yes, I see there's a.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Outpatient benefit certificate number is uh he's, it's an office visit, would that be it?
[AGENT][POSITIVE] Yes, that work
[CUSTOMER][NEUTRAL] 02337077 MLH
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] That is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, it looks like the policy is effective [PII]. It's currently active.
[AGENT][NEUTRAL] Let me get that policy pulled up and I'll give you those benefits. One moment.
[AGENT][NEUTRAL] Anything I quote is not a guarantee of payment. It's a basic outline of the policy.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] So he has a $1000 per cover person per calendar year benefit, but it does not cover office visits.
[CUSTOMER][NEUTRAL] OK, it doesn't cover office visits.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what does it cover?
[AGENT][NEUTRAL] Uh, it would be for like outpatient hospital services, ER, urgent care facility, um, so basically facility.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] Nothing in the office, correct.
[CUSTOMER][NEUTRAL] OK, so this is actually um a hospital policy.
[AGENT][NEUTRAL] Uh, it's a secondary policy, yes, um, all of these are typically related to facility charges, yes.
[CUSTOMER][NEUTRAL] So you're saying it's a secondary policy. Is this his primary insurance?
[AGENT][NEUTRAL] So this is a secondary policy, the one that you're that I just quoted.
[AGENT][NEUTRAL] Um, do you have his primary?
[CUSTOMER][NEUTRAL] Uh, what is this sorry?
[AGENT][NEUTRAL] Uh, let's see, it is.
[AGENT][NEUTRAL] I've got Amed, A V M E D.
[CUSTOMER][NEUTRAL] He has AME.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's primary.
[CUSTOMER][NEUTRAL] All right, uh, and.
[AGENT][NEUTRAL] Yes, that's
[CUSTOMER][NEUTRAL] Address for claims.
[AGENT][NEUTRAL] Address for claims is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And zip is [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] And timely filing.
[AGENT][NEGATIVE] Uh, there's no timely filing since this is secondary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is there a group number?
[AGENT][NEUTRAL] The group number is 23293.
[CUSTOMER][NEUTRAL] I'm sorry, I didn't write down your name. What did you say it is?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] [PII], you did say that. Thank you, [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][POSITIVE] Enjoy your afternoon.
[AGENT][POSITIVE] I hope you do too. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK bye.