AccountId: 011433970860
ContactId: dc2f2776-cf5c-4960-91bd-a1af85249116
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158059 ms
Total Talk Time (AGENT): 56078 ms
Total Talk Time (CUSTOMER): 74220 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/dc2f2776-cf5c-4960-91bd-a1af85249116_20250513T19:20_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good Afternoon. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm a nurse calling from Excel Orthopedics and I was calling to see if, um, my, uh, the physician I work for is in network with um your plan. Um there's a patient that has uh coverage through your plan and is scheduled to see our provider tomorrow, so I just wanna make sure that that is all in network.
[AGENT][NEUTRAL] OK. And what's that policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] It is 02514692.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Well, we don't have a network, so the policy is open, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, it's an open policy.
[AGENT][NEUTRAL] Yes, ma'am. They can go to a multi plan provider but the policy is a limited indemnity plan, so it just pays according to the plan, yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, limited indemnity. So what is her, is there like a max that you guys cover for medical expenses?
[AGENT][NEUTRAL] Uh, yes, ma'am. And depending on the pro uh procedure, if it's covered or not, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right well I will let the patient know and we'll um plan on keeping that appointment tomorrow.
[AGENT][NEUTRAL] OK. Well, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, um, or actually, is there an option for me to.
[CUSTOMER][NEUTRAL] Uh, I mean just to make sure that her coverage is active. I don't know, like normally insurance plans will check eligibility.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh yes, ma'am. Um, showing her effective date is [PII] and she is active on the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect that is all I needed.
[AGENT][POSITIVE] OK. Well, thank you for calling APL. Have a great day, Ms. [PII].
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] Mhm you too mhm bye bye.
[AGENT][NEUTRAL] Bye.