AccountId: 011433970860
ContactId: e2c33f26-f515-4d30-866f-21e45b99682d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265059 ms
Total Talk Time (AGENT): 97098 ms
Total Talk Time (CUSTOMER): 72773 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/e2c33f26-f515-4d30-866f-21e45b99682d_20250211T18:47_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, I'm a medical provider and I have a patient who sent me their supplementary card, and I wanted to know their benefits and if they're in network with me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's your name and the policy number?
[CUSTOMER][NEUTRAL] My name is [PII] and
[CUSTOMER][NEUTRAL] One second, the policy number is.
[CUSTOMER][NEUTRAL] I have the group number.
[AGENT][NEUTRAL] The policy number should be near the bottom, a policy certification number that begins with a 0.
[CUSTOMER][NEUTRAL] I, the card that they gave me says the inhospital benefit certification number.
[AGENT][NEUTRAL] There should be an outpatient certification number as well.
[CUSTOMER][NEUTRAL] Oh, OK, yeah, that one, sorry.
[AGENT][NEUTRAL] The number is the same before the elm, so just give me the numbers before the elm.
[CUSTOMER][NEUTRAL] OK, it's 024646.
[CUSTOMER][NEUTRAL] 47
[AGENT][NEUTRAL] OK. And, and spell your name.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] sorry, [PII]
[AGENT][NEUTRAL] OK, say that one more time because you were cutting in and out.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And how do you pronounce your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Let me pull up the policy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Their name is [PII], and their date of birth is [PII].
[AGENT][POSITIVE] All right, thanks for that information.
[AGENT][NEUTRAL] [PII]. And how can I help you today?
[CUSTOMER][NEUTRAL] Um, I wanted to know their benefits and if I was in network with them.
[AGENT][NEUTRAL] OK, and what type of service is it for? In a doctor's office?
[CUSTOMER][NEUTRAL] Yes, the primary care provider.
[AGENT][NEUTRAL] OK, there's no network affiliated with this Melink policy cause it's secondary to the major medical plan and so we follow the major medical policy.
[AGENT][NEUTRAL] And did you say this is a specialist or PCP?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] PCP
[AGENT][NEUTRAL] PCP OK.
[AGENT][NEUTRAL] Let's see, so I'm showing an effective date of [PII].
[AGENT][NEUTRAL] Policy is active at this time, excuse me.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] So for a physician office visit fee, this policy covers up to $25 per visit.
[AGENT][NEUTRAL] And the maximum number of visits um are 4 per calendar year per covered person, and then 8 per calendar year for all covered persons combined.
[AGENT][NEUTRAL] And let's see if any has been used. I don't show any of those visits used this year.
[AGENT][NEUTRAL] And of course the information provided is verification, not a guarantee of payment. And did you have any other questions?
[CUSTOMER][POSITIVE] Um, no, that's all. Thank you.
[AGENT][POSITIVE] Alright, [PII], thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][NEUTRAL] Bye-bye.