AccountId: 011433970860
ContactId: d0f93aa6-9149-4f7a-9b17-25d2743e02c3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204320 ms
Total Talk Time (AGENT): 102761 ms
Total Talk Time (CUSTOMER): 84655 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/d0f93aa6-9149-4f7a-9b17-25d2743e02c3_20250530T14:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I'm not sure if I pushed the right button. I'm just trying to verify insurance though.
[AGENT][NEUTRAL] OK, I can help you verify benefits. What's the policy number?
[CUSTOMER][NEUTRAL] Um, 0265, sorry, that's wrong, 02625122.
[AGENT][NEUTRAL] Alright, let me.
[CUSTOMER][NEGATIVE] Like you see the number and it just doesn't come out of the mouth I don't know.
[AGENT][NEUTRAL] All right. And then for documentation, can I grab your first name, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you [PII].
[AGENT][NEUTRAL] And then if I can get patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date is [PII].
[AGENT][NEUTRAL] Uh, is the patient being seen for like an office visit or?
[CUSTOMER][NEUTRAL] Yeah it'll be more of a specialist though.
[AGENT][NEUTRAL] OK, let me see here.
[AGENT][NEUTRAL] So the plan type is a limited benefit hospital indemnity plan. It just pays a set amount depending upon what they're being seen for.
[AGENT][NEUTRAL] And it looks like.
[AGENT][NEUTRAL] On this, um, they're outpatient for a physician's office. Max is gonna be $100 per day, and they're allotted up to 4 visits in a calendar year.
[CUSTOMER][NEGATIVE] OK, that's kind of bad 4 visits per year.
[AGENT][NEUTRAL] Mhm. Correct, yeah.
[CUSTOMER][NEUTRAL] Does this person know this?
[AGENT][NEUTRAL] I'll be honest with you, a lot of people that have these sometimes soon don't realize exactly what type of plan it is. I know.
[CUSTOMER][NEUTRAL] Yes, yes, I hope it's super duper cheap, but um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So yeah, it, it pays $100 towards the visit and then you know it's up to the facility, yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] He pays the rest so if the visit's $5000 you're only paying $100 no matter what, and he owes the $49 OK.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] As long as I kind of understand that.
[AGENT][POSITIVE] Yeah, absolutely. Do you have any other questions, concerns?
[CUSTOMER][NEUTRAL] Um, up to 4 visits per doctor or 4 visits total?
[AGENT][NEUTRAL] 4 visits total for the calendar year per covered person. Mhm.
[CUSTOMER][NEUTRAL] Total.
[CUSTOMER][NEUTRAL] So in other words, he can only go to a doctor, whether it's a dermatologist one time, an orthopedic another time, uh.
[CUSTOMER][NEUTRAL] I call doctor another time, only 4 doctor visits a year.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] If I can get a call reference number and your name again, I know, I think it was [PII], correct?
[AGENT][NEUTRAL] Yeah, and uh the call reference is actually my name with today's date, so you can use [PII], which is [PII] initial to my last name is gonna be [PII] and then today's date.
[CUSTOMER][NEUTRAL] And where are we? The [PII] or the [PII], OK, OK, perfect, thank you so much. Oh, where do we mail the claims to? Um, is it to the, uh, [PII]? I mean, I'm looking at the card, so I'm hopefully it's all the same.
[AGENT][NEUTRAL] [PII], yeah.
[AGENT][POSITIVE] You're welcome. Have a good 10.
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes ma'am, that is correct uh huh.
[CUSTOMER][POSITIVE] OK perfect perfect thank you.
[AGENT][NEUTRAL] Uh huh bye bye.