AccountId: 011433970860
ContactId: f01cd9e0-ddd9-4b35-a17c-eff089fd5cea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 403709 ms
Total Talk Time (AGENT): 167824 ms
Total Talk Time (CUSTOMER): 158440 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/f01cd9e0-ddd9-4b35-a17c-eff089fd5cea_20250224T21:14_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] This is who I'm sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], OK, Miss. [PII], this is [PII]. I am calling from Hope Physician, and we have Mr. [PII] in our office and, um, I need to verify some information. I need to see if he is, um, hold on just a second, my computer is acting dumb and stupid. Hold on just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I didn't want my screen to go blank and it was just before going blank.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and his date of birth is [PII] and I am calling from Hope.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] The policy number is 64.
[CUSTOMER][NEUTRAL] 5.
[CUSTOMER][NEUTRAL] And looks like 56.
[CUSTOMER][NEUTRAL] It's kind of blurred, I mean.
[CUSTOMER][NEUTRAL] I don't know where he got this.
[AGENT][NEUTRAL] Spell spell the patients that look that looks like a payer ID number. Spell the patient's first and last name.
[CUSTOMER][NEUTRAL] OK, [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The first name is [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I am looking.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I'm sorry, but I do not.
[CUSTOMER][NEUTRAL] I don't see it.
[AGENT][NEUTRAL] Yeah, I can look it up by his name.
[CUSTOMER][POSITIVE] OK, I'm sorry.
[AGENT][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] And you said the spelling of the first name is [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Would you happen to have a social security number for the insured?
[CUSTOMER][NEUTRAL] Yes, yes ma'am, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Mhm thank you.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] And give me the date of birth again.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, [PII]. So we have his first name is [PII]. His last name is [PII] Is that right? Or do you, do I have it reversed?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No ma'am, we have a [PII].
[AGENT][NEUTRAL] And then last name is [PII].
[CUSTOMER][NEUTRAL] No, no, ma'am, his last name is [PII] and his first name is [PII]. Yes, ma'am, and his first name is [PII]
[AGENT][NEUTRAL] Oh, [PII] OK. OK.
[AGENT][NEUTRAL] I got it.
[AGENT][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] It's OK. I put it in the system backwards. That's why I didn't pull up, but I found it. um, let me give you the.
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] That's OK. Don't be sorry. It's OK.
[AGENT][NEUTRAL] So let me give you the policy number.
[AGENT][NEUTRAL] It is 25 it's 253.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 888 9.
[AGENT][NEUTRAL] And the policy effective date is [PII]. Policy is active at this time, and [PII], were you calling for a claim status or benefits?
[CUSTOMER][NEUTRAL] Benefits I need to see if if he has a deductible and if so how much and if the deductible is met excuse me, I'm sorry.
[AGENT][NEUTRAL] OK. Are you a medical or dental provider?
[CUSTOMER][NEUTRAL] I am calling from Hope Physicians.
[AGENT][NEUTRAL] OK, and so would this be for an office visit?
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So there is no deductible, uh, under this policy. It's a limited hospital indemnity plan for an office visit. This policy covers up to $75.
[AGENT][NEUTRAL] Per visit.
[AGENT][NEUTRAL] And then a maximum of 5 visits.
[AGENT][NEUTRAL] Per, uh, calendar year. Um.
[AGENT][NEUTRAL] And this is an individual policy, so up to 5 visits per calendar year.
[CUSTOMER][NEUTRAL] OK, so you mean that it only pays $75 on the office visit and the patient has to pay the rent.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Well, the, uh, number that the 64556 number, well, that's the payer ID number to send the claim, are you familiar with multi-plan PPO network of contracted providers?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Our insurance, our insurance probably is our insurance personnel probably is.
[AGENT][NEUTRAL] OK, if the offices or the doctors contracted with that network, it could perhaps uh get a, he could get a discount of some sort, perhaps.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it pays 75 days per visit.
[CUSTOMER][NEUTRAL] $75.
[AGENT][NEUTRAL] Up to 75 per visit, yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and your name was [PII]?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] I'm sorry, well, see, I've, look, I've spoken to 4 since I dialed this number. I have spoken to you're the 4th person I've spoken to, OK, and you said [PII]
[AGENT][NEUTRAL] Yeah, [PII] is, [PII] is with 90 Degrees, um, and she pro she probably transferred you over. [PII] is on top.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And first in first initial of my last name is [PII]. You'll use my name and today's date as reference for today's call and [PII], any information provided today is verification, not a guarantee of payment. Did you have any other questions?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No ma'am, that's it.
[AGENT][NEUTRAL] OK. All right, well.
[CUSTOMER][POSITIVE] All right thank you you have a blessed day.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][POSITIVE] Uh huh thank you uh bye bye.