AccountId: 011433970860
ContactId: e8a11e20-81c1-4709-9972-6a6820a1cfd4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168399 ms
Total Talk Time (AGENT): 91136 ms
Total Talk Time (CUSTOMER): 58978 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/e8a11e20-81c1-4709-9972-6a6820a1cfd4_20250318T18:48_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, my name is [PII]. I'm calling from Mount Sinai Department of Orthopedics, and I wanted to confirm if one of our providers is participating with this member's plan.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yes I do. It is 02597230.
[AGENT][POSITIVE] Thank you. And
[AGENT][NEUTRAL] [PII], what is a good callback number, please?
[CUSTOMER][NEUTRAL] My direct line is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I can help you with that information, [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Now, with this policy, it does participate in the multi-plan network. However, network participation is not required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So we, we pay claims in and out of network.
[CUSTOMER][NEUTRAL] OK perfect so if the provider is in network with multi plan then he should be covered.
[AGENT][NEUTRAL] So with our, yeah, with our policy if the benefit is covered, we're going to pay it um.
[CUSTOMER][NEUTRAL] Well, regardless, mhm.
[AGENT][NEUTRAL] If your provider is in the multi-play network, then he would receive that.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Repricing through multiplan, but with our policy, there's no contractual involvement in the processing of our claim. It's a limited indemnity policy, so we pay the policy benefit regardless of network participation.
[CUSTOMER][POSITIVE] Oh perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. And uh does this plan require a referral to see a specialist or any copays to see a specialist?
[AGENT][NEGATIVE] It does not. No referral and there are no co-pay, deductibles or co-insurance on this plan.
[CUSTOMER][POSITIVE] Oh perfect.
[CUSTOMER][POSITIVE] Great thank you so much this is actually all I need for today.
[CUSTOMER][NEUTRAL] Is there a reference number for our call?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] It's gonna be my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] And it has been a pleasure to assist you with that network information. Anything else I can help you with today?
[CUSTOMER][POSITIVE] Great thank you.
[CUSTOMER][POSITIVE] Thank you so much. That would be all, thank you.
[AGENT][POSITIVE] [PII], thank you for calling APL. Hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.