AccountId: 011433970860
ContactId: e4e83338-ef27-47e6-b71b-93e9da14281b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264519 ms
Total Talk Time (AGENT): 127452 ms
Total Talk Time (CUSTOMER): 110592 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/e4e83338-ef27-47e6-b71b-93e9da14281b_20250313T12:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling from doctor's care. I just need to verify eligibility on a patient.
[AGENT][POSITIVE] OK, I can definitely help you with the eligibility. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, the number here is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh, the number is D as in Delta 43732625.
[AGENT][NEUTRAL] And do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] On the card, do you see anywhere that says inpatient or outpatient policy er number?
[CUSTOMER][NEUTRAL] Um, no, no, I don't.
[AGENT][NEUTRAL] Do you see APL to the top left corner?
[CUSTOMER][NEUTRAL] No, I don't.
[CUSTOMER][NEUTRAL] Uh, it is APL.
[AGENT][NEUTRAL] OK, do you see anywhere that says it should start with a 01 or 02?
[CUSTOMER][NEUTRAL] Oh, policy, sir. OK, 020, 02596509.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Is that the number we should put down for the ID number? The 02 number? OK, OK, let me change that while you do that.
[AGENT][NEUTRAL] Yes, ma'am. That's the policy number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I have the policy here and I just need you to verify the first and last name and date of birth.
[CUSTOMER][NEUTRAL] Uh his date of birth is [PII]. His last name is [PII], and his first name is [PII]
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] OK, active, is there a copay? We're urgent care now. What is the co-pay for urgent care?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me um pull the benefits. Hold on one second.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so it's coming up now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said urgent care? OK.
[CUSTOMER][NEUTRAL] Right, we're urgent care now.
[AGENT][NEUTRAL] OK, so the, so the policy itself is a hospital indemnity policy, so it's a limited benefit plan. So for emergency room or visits, um, that would probably use the outpatient sickness rider, which is up to $75 per visit with a max of 5 visits per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So what would he pay today?
[AGENT][NEUTRAL] Um, we're on the back end after the claim is filed. So if y'all.
[CUSTOMER][NEUTRAL] So don't collect so file first, right? File first?
[CUSTOMER][NEUTRAL] File first.
[AGENT][NEUTRAL] Right, it's up to you as a provider. We don't really determine that. If you'd like to file first, um, we'll handle it on the back end or if you want them to pay, we, you know.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Look.
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] scene
[AGENT][NEUTRAL] We handle everything on the back end. So however you wanna do it, that's what we can't really advise.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so I just don't know what to collect.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Because uh
[CUSTOMER][NEUTRAL] I don't know what to cut.
[AGENT][NEUTRAL] The policy itself like doesn't have a co-pay or anything. So if there was something to collect, it would be like a self-pay fee maybe, but as far as insurance, there is nothing.
[CUSTOMER][NEUTRAL] I is there a is there a deductible on the policy?
[AGENT][NEUTRAL] Uh, I don't believe so. Let me double check. Hold on one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, I'm just file first. I don't know. I'll file first and then you take care of it, right? Yeah, I don't know.
[AGENT][NEUTRAL] Ah
[AGENT][NEUTRAL] Right, well, definitely, um.
[CUSTOMER][NEUTRAL] That'll that'll be OK.
[AGENT][POSITIVE] Yeah, that's totally fine.
[CUSTOMER][POSITIVE] OK, alright, I'll do that. I appreciate your help.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, you were great, thank you.
[AGENT][POSITIVE] You're welcome. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you, [PII]. Bye-bye.