AccountId: 011433970860
ContactId: d0097660-f597-4745-8580-db007d18da4d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270519 ms
Total Talk Time (AGENT): 107578 ms
Total Talk Time (CUSTOMER): 58355 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/d0097660-f597-4745-8580-db007d18da4d_20250121T21:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. Uh, this is [PII] and I'm calling from the doctor's office to checking the eligibility and benefits.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits [PII]. Can you please give me your call back number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Oh, sure. The callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Uh, the patient's first name is [PII] and the last name is [PII].
[AGENT][NEUTRAL] OK. And then what is the patient's date of birth?
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[AGENT][NEUTRAL] OK, and patient's policy number, please?
[CUSTOMER][NEUTRAL] Uh, yes, the policy number is 02585067.
[AGENT][NEUTRAL] OK, let me pull that policy in real quick.
[AGENT][NEUTRAL] OK, looking at the policy for [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] They do have an active policy and the effective date is [PII].
[AGENT][NEUTRAL] And this is um just to verify coverage it's not a guarantee of payment. This is a hospital indemnity plan. It's a limited insurance plan that helps uh if the insured goes into the hospital. It has a hospital admission benefit on the first day of the calendar year of $1000 and then hospital confinement for 18 hours or more.
[AGENT][NEUTRAL] Is $100 for 30 days per calendar year.
[CUSTOMER][NEUTRAL] Oh, OK, now I got it. Uh, because the patient wanted to see the doctor at clinic, so, uh, the insurance will not cover, right?
[AGENT][NEUTRAL] Let me look and see let me pull up because some of them do have writers that allow that but let me check and look at this policy and make sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me look, it's gonna be just a second because I actually have to pull up the policy and read it, so it's gonna be just a moment.
[CUSTOMER][NEUTRAL] Oh sure
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK, it does cover for a physician's office for outpatient accident or sickness.
[CUSTOMER][NEUTRAL] Oh, OK. On 4.
[CUSTOMER][NEUTRAL] The sickness and accident, OK.
[AGENT][NEUTRAL] For accident, yes.
[CUSTOMER][NEUTRAL] And could you please also provide me the call reference number for this call?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much for providing me the information. I really appreciate.
[AGENT][POSITIVE] You're very welcome, [PII]. I hope you have a good rest of your week and thank you for calling APL.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.