AccountId: 011433970860
ContactId: e5bb8fb5-e879-4fbb-9caa-8149aa41b328
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328559 ms
Total Talk Time (AGENT): 127122 ms
Total Talk Time (CUSTOMER): 123211 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/e5bb8fb5-e879-4fbb-9caa-8149aa41b328_20250513T20:04_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII].
[AGENT][NEUTRAL] What was your name?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Can I have a callback number for you and the reason for your call and I'll be able to assist you.
[CUSTOMER][NEUTRAL] It's a callback number [PII].
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] And the reason for your call?
[CUSTOMER][NEUTRAL] I am calling from an urgent care, so I just want to know if this patient has out of network benefits.
[AGENT][NEUTRAL] Can I have a policy number to verify that member's policy?
[CUSTOMER][NEUTRAL] Uh, I don't have the policy number. I just have the information of the of the holder, the insurance holder, and the dependent insurance.
[AGENT][NEUTRAL] So do you have a social of the primit of the policy holder? What do you have for me to look up the policy?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] So I just got transferred from the from from the other um the benefits cards. I just got transferred so they didn't provide me with the member ID or anything.
[AGENT][NEUTRAL] And they didn't give you a policy number?
[AGENT][NEUTRAL] So did the, did the member provide you with any information to for us to be able to pull up the policy?
[CUSTOMER][NEGATIVE] They did not.
[CUSTOMER][NEUTRAL] No, he, he doesn't have.
[CUSTOMER][NEUTRAL] He doesn't have uh his member ID because he said he recently got insurance from his job, so he doesn't have a member ID yet.
[AGENT][NEUTRAL] So he didn't give you his social either, the social security number?
[CUSTOMER][NEUTRAL] OK, let me just grab that. May I have your social security number, please?
[CUSTOMER][NEUTRAL] You can just write it down here.
[CUSTOMER][NEUTRAL] To try this to social, OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I can't, I, um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. What is this member's name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Birthday is [PII].
[AGENT][NEUTRAL] So [PII] is the patient as well?
[CUSTOMER][NEUTRAL] Um, and the dependent, um, he's not, he's not, he's not gonna be the patient, the dependent is gonna be the patient.
[AGENT][NEUTRAL] Did I have the patient's name and date of birth? Did it help out a lot?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And the birthday is [PII].
[AGENT][POSITIVE] Thank you, so let me give you the correct policy number.
[CUSTOMER][NEUTRAL] All right. Please.
[AGENT][NEUTRAL] It's 262-1218. It's 2621218 is the correct policy number here at American Public Life.
[CUSTOMER][NEUTRAL] OK. 262-1218.
[AGENT][NEUTRAL] This policy has been active since [PII].
[CUSTOMER][NEUTRAL] It's acting for me fine I think. OK, um, does the patient has any out of network benefits for urgent care because we are not in network with them. We don't participate.
[AGENT][NEUTRAL] So this policy does not have a network. This is not a network policy. This is a policy where the member can go wherever they desire to go. This is a hospital indemnity policy and the member has office visits.
[AGENT][NEUTRAL] 4 office visits per visit with.
[AGENT][NEUTRAL] Each visit being paid, looks like.
[AGENT][NEUTRAL] Um, $100 but let me transfer you to the correct department so they can assist you with these benefits because I don't wanna give you the wrong ones. Hold on, OK? Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I don't know about it.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey, [PII], how are you doing?
[CUSTOMER][POSITIVE] I'm doing good. How are you doing?
[AGENT][NEUTRAL] I'm great, thanks for asking, [PII]. I have a provider on the phone who's calling about benefits for HR policy. She wanna verify if urgent care is covered under the policy.
[CUSTOMER][NEUTRAL] OK, alright, what's the um policy number that she's calling about? Do you have that?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It's 262-1218.
[CUSTOMER][NEUTRAL] OK, you can go ahead and send her on over to me.
[AGENT][NEUTRAL] Alright, do you see the callback number on the um the [PII]. This is the provider. Her name is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 01 moment.
[CUSTOMER][NEUTRAL] [PII]. Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Hello [PII], I'm gonna send you transfer you over to [PII]. She's gonna better assist you. Thanks for calling APL and have a good day. Goodbye. Thank you, [PII].
[CUSTOMER][NEUTRAL] Yeah, I've got her.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.