AccountId: 011433970860
ContactId: e0141003-2cf1-4fee-ba71-0e9c7a9688b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 373359 ms
Total Talk Time (AGENT): 144800 ms
Total Talk Time (CUSTOMER): 152301 ms
Interruptions: 3
Overall Sentiment: AGENT=0.9, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/e0141003-2cf1-4fee-ba71-0e9c7a9688b3_20250404T15:13_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] He had a primary.
[CUSTOMER][NEUTRAL] And, and, and signa was secondary. Uh, yes, hello, my name is [PII]. I'm calling from the office of Doctor [PII], and I need to uh obtain benefits for a patient.
[AGENT][POSITIVE] Sure, I can assist you with that.
[CUSTOMER][NEUTRAL] 4.
[AGENT][NEUTRAL] Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] And a callback number for you [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the policy number of the member that you're calling to verify benefits and eligibility for?
[CUSTOMER][NEUTRAL] It's 02597089.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh [PII] I mean sorry, [PII] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] You're calling to verify benefits and eligibility for what place of service?
[CUSTOMER][NEUTRAL] Uh, for medical PCP office primary doctor.
[CUSTOMER][NEUTRAL] Do they have benefits for that?
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So this is a hospital indemnity policy and she does have a sickness rider. PCP will pay up to $75 per visit.
[CUSTOMER][NEUTRAL] I'm sorry, you, uh, I'm sorry, you said so this is a hospital a minute, so they do have like sick sick visits with the primary doctor?
[AGENT][NEUTRAL] Right, she does, and she, we will pay up to $75 per visit with 5 visits per calendar year.
[CUSTOMER][NEUTRAL] OK, so my main question, oh.
[AGENT][NEUTRAL] This is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] What is the network that y'all follow?
[AGENT][NEGATIVE] There is no network.
[CUSTOMER][NEUTRAL] There's no network?
[AGENT][NEUTRAL] No, there isn't.
[CUSTOMER][NEUTRAL] OK, there's OK and what is the payer ID?
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Patient
[AGENT][NEUTRAL] So the payer ID is 60801.
[CUSTOMER][NEUTRAL] 260.
[AGENT][NEUTRAL] 801.
[CUSTOMER][NEUTRAL] 801 and the claims address is the um [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, so pretty, so pretty much this is just like an open like a PPO open access plan with no network.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] Yeah, um.
[CUSTOMER][NEUTRAL] Open access, OK, um, and for lab work if they do, let's say they order some blood work, do you do quest or lab corp?
[AGENT][NEUTRAL] Um, I'm actually not sure. I can transfer you to the actual queue for them to better assist you. I can only provide the benefits from reading what is in the system.
[AGENT][NEUTRAL] So would you like for me to transfer you into the proper queue?
[CUSTOMER][NEUTRAL] OK, alright, no that's fine what.
[CUSTOMER][NEUTRAL] Yeah, that's fine. Can I get your name?
[AGENT][NEUTRAL] My name is [PII], and today's date is reference.
[CUSTOMER][POSITIVE] OK, thank you so much I really appreciate it.
[AGENT][POSITIVE] Hold one moment [PII]. You're welcome. Thanks for calling APL. Have a good day. Hold one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], how are you doing?
[CUSTOMER][POSITIVE] I'm doing well how are you doing today?
[AGENT][POSITIVE] I'm great, thanks for asking [PII]. [PII], um.
[AGENT][NEUTRAL] I'm typing and trying to, I have a provider on the phone. She's calling about a HR policy and she wants to verify benefits for lab.
[AGENT][NEUTRAL] Refund
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Policy number, let me know when you're ready for it.
[CUSTOMER][POSITIVE] I'm ready, sir.
[AGENT][NEUTRAL] It is 259-7089. It's 2597089.
[AGENT][NEUTRAL] Calling about part two.
[CUSTOMER][NEUTRAL] What's the patient's name.
[CUSTOMER][NEUTRAL] I want to know about independent lab benefits.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what is her name or his name?
[AGENT][NEUTRAL] [PII] and her callback number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I'm sorry, [PII], yeah.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] got you.
[CUSTOMER][NEUTRAL] And her name is [PII]?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm. Her name is [PII] like yours.
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Hold one moment, OK, [PII]? I'm gonna transfer her home.
[CUSTOMER][POSITIVE] And calling. Thank, thank you, [PII]. Have a great weekend. I was just gonna say have a great weekend.
[AGENT][NEUTRAL] What you was about to say?
[AGENT][POSITIVE] Thank you. You do the same. Thank you. [PII], was you at the meeting the other day?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I was.
[AGENT][NEUTRAL] I didn't, I don't remember seeing you.
[CUSTOMER][NEUTRAL] I didn't, I don't, you know, I didn't see it, it, I don't know why, but I just didn't see a lot of people, but I mean, I know a lot of people were there.
[AGENT][NEUTRAL] That cause I, when you, when you answered the phone, I was like, did I see [PII] this week? I don't remember seeing her but.
[CUSTOMER][NEUTRAL] I was doing the same thing, so.
[CUSTOMER][POSITIVE] That's funny.
[CUSTOMER][NEUTRAL] I like, I didn't see [PII].
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, I was there.
[AGENT][NEUTRAL] 01 moment, [PII].
[CUSTOMER][POSITIVE] Well, I'm sorry I missed you. Thank you. Have a great weekend.
[AGENT][NEUTRAL] I know, right. Hold one moment. You do the same. Goodbye.
[CUSTOMER][POSITIVE] Take care. Bye bye.
[AGENT][POSITIVE] Hello [PII]. I'm gonna transfer you over to [PII]. She's gonna better assist you, OK? Thanks for calling APL and have a good day. You're welcome. Goodbye.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] Thank