AccountId: 011433970860
ContactId: dd2f836c-9ee0-47a1-b6c9-5f2819b07e96
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236389 ms
Total Talk Time (AGENT): 77712 ms
Total Talk Time (CUSTOMER): 78500 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/dd2f836c-9ee0-47a1-b6c9-5f2819b07e96_20250609T19:21_UTC.wav
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[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] Thank you for calling. Good afternoon. APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling from my dermatology to verify patient patient's eligibility and benefits.
[AGENT][NEUTRAL] OK, and did you say your name is [PII]?
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][POSITIVE] Thank you and your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you very much and what is that policy number, please?
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] My apologies, it's 0 outpatient 02559122.
[CUSTOMER][NEUTRAL] M as in Mary
[CUSTOMER][NEUTRAL] L as in lion 8.
[AGENT][POSITIVE] OK, thank you very much. One moment please, [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Verify the patience. You're welcome. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK, thank you, and you're calling for eligibility and outpatient benefits. Give me one moment to help you with that.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Thank you. And this policy shows effective as of [PII]. This policy shows active. This be for a facility setting or an office visit setting?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, let's see what else I need.
[CUSTOMER][NEUTRAL] Are there any specialist copays or deductibles?
[AGENT][NEUTRAL] OK, the policy does not cover for an office visit fee whether with a PCPR specialist.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] So it does not cover, however, it is a secondary to Cigna, so will it cover for deductible and everything else?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It covers well helps with deductibles, co-pays, and co-insurance based on coverage with us. It's just in this particular case, the policy does not cover for an office visit fee.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it, no problem.
[CUSTOMER][NEUTRAL] OK, for this plan, is it an HMO PPO or POS plan?
[AGENT][NEUTRAL] And there's no um plan type. It's just a supplemental medical policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you, what is the medical claims address?
[AGENT][NEUTRAL] APL claims.
[AGENT][NEUTRAL] PO Box 248,950.
[AGENT][NEUTRAL] Excuse me. Oklahoma City, Oklahoma.
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] 73124.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Who put this chart in room 18.
[CUSTOMER][POSITIVE] Alright thank you for that.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] I believe what is your name please?
[AGENT][NEUTRAL] My name is [PII] with last initial [PII].
[CUSTOMER][NEUTRAL] And may I have a reference number for this call, please?
[AGENT][NEUTRAL] We do not use reference numbers [PII], but you can use my name and today's date.
[CUSTOMER][NEUTRAL] They're not here yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you very much Miss [PII]. Enjoy the rest of your day.
[AGENT][POSITIVE] And thank you for calling APL. You have a great day as well, [PII]. Thank you and take care.
[CUSTOMER][POSITIVE] Thank you bye.