AccountId: 011433970860
ContactId: df48e004-65b8-480e-b676-7dc9faea7a38
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243580 ms
Total Talk Time (AGENT): 78391 ms
Total Talk Time (CUSTOMER): 50760 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/df48e004-65b8-480e-b676-7dc9faea7a38_20250527T20:28_UTC.wav
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[CUSTOMER][NEUTRAL] I just
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I think so. I haven't.
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling um to verify if a patient's policy covers their primary's urgent care call please.
[AGENT][NEUTRAL] OK, can I get your name and a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII]. The contact number is [PII].
[AGENT][NEUTRAL] OK, and do you have the policy name or policy number? I'm sorry.
[CUSTOMER][NEUTRAL] Um, yes, it is 1419025 ML 8.
[AGENT][NEUTRAL] OK, give me one moment while I pull that up.
[AGENT][NEUTRAL] Can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat that?
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] Oh yes, it's [PII], um, [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] This policy is active with an effective date of [PII], and you're wanting to know if that helps with co-pay?
[CUSTOMER][NEUTRAL] Yes, for urgent care.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I will say that this is secondary gap insurance so we will need the primary EOB um for this.
[AGENT][NEUTRAL] And you said urgent care?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull that up and check.
[AGENT][NEUTRAL] OK, now this is a verification of benefits and not a guarantee of payment. I'm showing for this policy they have an outpatient benefit maximum of up to $1000 per covered person per calendar day.
[AGENT][NEUTRAL] With a $0 outpatient deductible.
[AGENT][NEUTRAL] And it can be used in an urgent care facility with the maximum of 30 days of treatment per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, perfect. um, do you have a reference number for the call?
[AGENT][NEUTRAL] We don't have reference numbers, but you can use my name and last initial in today's date, so [PII].
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that'll be all thank you.
[AGENT][POSITIVE] Great thank you so much for calling APL Carla. Have a great day.
[CUSTOMER][POSITIVE] You too thank you.