AccountId: 011433970860
ContactId: dffc7894-1ade-4b10-b513-21f959068723
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157949 ms
Total Talk Time (AGENT): 72195 ms
Total Talk Time (CUSTOMER): 37341 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/dffc7894-1ade-4b10-b513-21f959068723_20250501T20:59_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm with Matthewsville Medical Group, and I just need to verify eligibility for a patient.
[AGENT][POSITIVE] Yeah, I can check eligibility for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it's 02573216.
[AGENT][NEUTRAL] Got it. And what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that, [PII]. So this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with copay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] OK, and so it helps after the primary?
[AGENT][NEUTRAL] Correct, it is dependent on the primary uh if they are not willing to pay this policy can't.
[CUSTOMER][NEUTRAL] And is there any co-pay itself for the plan?
[AGENT][NEUTRAL] Uh, this policy doesn't have any co-pays. Uh, let me see if there is a deductible for this one.
[AGENT][NEUTRAL] No, no copays, no deductibles unless it was for um an emergency room visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so for a regular office visit, um, we can use this as a secondary insurance.
[AGENT][NEUTRAL] Let me see if office visits are covered under this policy. Just give me one moment. Um, some of them have that, some of them do not, and of course I will let you know verification of coverage is not a guarantee of payment for claims.
[AGENT][NEUTRAL] So for this policy, office visits are not going to be covered. Uh, neither will treatment received in office unless it was uh specifically for cancer.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] Yeah, is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] Alright yeah thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.