AccountId: 011433970860
ContactId: ed1b4360-069a-4496-b270-132074c8dd21
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210850 ms
Total Talk Time (AGENT): 101837 ms
Total Talk Time (CUSTOMER): 67603 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/ed1b4360-069a-4496-b270-132074c8dd21_20250403T20:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Oh, I'm just needing to check your members um benefits and eligibility.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits and eligibility. May I have your name?
[CUSTOMER][NEUTRAL] Hi, [PII].
[AGENT][NEUTRAL] And Ms. [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. What's the name of the facility you're calling from, Ms. [PII]?
[CUSTOMER][NEUTRAL] Uh, Family care wellness.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, um, it is 02435048.
[AGENT][NEUTRAL] Thank you. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Um, it is [PII]. My date of birth is [PII].
[AGENT][POSITIVE] Alright, perfect, thank you. And what type of services being rendered?
[CUSTOMER][NEUTRAL] Um, it's for a will or a, a primary care visit.
[AGENT][NEUTRAL] Primary care, OK.
[AGENT][NEUTRAL] All right, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And we have one of our um limited policies. This is a limited hospital indemnity plan.
[CUSTOMER][NEUTRAL] There's.
[AGENT][NEUTRAL] And let's see for the office visit, we have a benefit amount of $50 per visit, maximum of 4 visits per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, so it only covers 4 visits per calendar year.
[AGENT][NEUTRAL] Yes, uh, at $50 each. Mhm.
[CUSTOMER][NEUTRAL] OK. Give me 1 2nd.
[AGENT][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] OK, that's fine, and you said it's a $50 co-pay for that?
[AGENT][NEUTRAL] Uh no, that's not a copay. That is a flat amount. This is an indemnity policy, which is a limited policy, and it pays a flat amount. So $50 is what we covered.
[CUSTOMER][NEUTRAL] Yeah, OK, so you'll cover $50.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, up to 4 business per year.
[CUSTOMER][NEUTRAL] Alright and um I think that's it. I just need a reference number for a call.
[AGENT][NEUTRAL] OK, we don't have reference numbers you can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Just the spelling of your name.
[AGENT][NEUTRAL] Sure, that's [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] And then you said today's date?
[AGENT][POSITIVE] Yes, mhm, that's correct.
[CUSTOMER][NEUTRAL] OK, I will, um.
[CUSTOMER][POSITIVE] Oh, well, that was it. I'm sorry about that. Um, what's in my mind, I reckon.
[AGENT][NEGATIVE] No, no.
[AGENT][NEUTRAL] It's just fine. Is there anything else I'm gonna help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Oh, that's, that'll be it.
[AGENT][POSITIVE] All right, well, you have a good afternoon and thank you for calling APO.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.