AccountId: 011433970860
ContactId: cffc3406-2157-45a6-bef5-268c79938ac7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326380 ms
Total Talk Time (AGENT): 109561 ms
Total Talk Time (CUSTOMER): 84199 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/cffc3406-2157-45a6-bef5-268c79938ac7_20250206T20:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Hi, [PII]. I am an outpatient therapist and I have a client who just gave me this. She had an insurance change and she um just gave me this insurance information, and it's actually an insurance I've never even heard of. So I don't know, I don't know if I, if it's possible to get credentialed with this in my state or if I need to tell her that it's something that I don't, just don't accept.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] No worries I can get that policy pulled up and we can uh just see what kind of policy it is and we could go from there. um I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK and then can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] OK, thank you. And then did you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02585337.
[AGENT][NEUTRAL] OK, thank you. And then what was the name and date of birth for the patient?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Her name is [PII]. Uh, it might be
[CUSTOMER][NEUTRAL] She goes by [PII], but her first names, I think it's [PII].
[AGENT][NEUTRAL] OK. And do you have her date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. All right, so this plan is definitely a bit more of our confusing ones um it is a limited indemnity medical plan, so in short, there is no network, um, no copay, no deductible.
[AGENT][NEUTRAL] It is quite limited, uh, and it pays a set dollar amount per procedure or office visit. Um, it's a bit different than traditional major medical like Blue Cross or Aetna in the fact that again very limited and then it's just here's how much it will pay for this procedure and so on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That you would just file those claims and send them directly to us.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I'm sorry, it cut out when you were saying that. Could you repeat that?
[AGENT][NEUTRAL] Oh, sorry.
[AGENT][NEUTRAL] Yes, um, so you would just file the claims directly to us.
[CUSTOMER][NEUTRAL] OK, but so I don't necessarily need to get like credentials with you?
[AGENT][NEUTRAL] No, nothing like that. It's again, it's very different than traditional major medical.
[CUSTOMER][NEUTRAL] OK. So, and, and is mental health um covered under that as well or just medical?
[AGENT][NEUTRAL] Let me take a look. Um, they're all a bit different, so I will see if that's a benefit under this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you say mental health, do you mean like um therapy, medication, or um
[CUSTOMER][NEUTRAL] Yeah, I'm an outpatient therapist, so it would be for outpatient sessions.
[AGENT][NEUTRAL] Oh, it is for therapy. OK, I see. Give me just a moment.
[AGENT][NEUTRAL] So not like a traditional um physician's office, it is an actual therapy facility.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Give me just a moment, let me see.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bear with me. I'm just getting the policy pulled up.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Sure, no problem.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and of course I will let you know uh verification of coverage is not a guarantee.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Did I lose you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Hello?