AccountId: 011433970860
ContactId: f1693636-9bcc-4365-a699-b0c199693b8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171380 ms
Total Talk Time (AGENT): 96849 ms
Total Talk Time (CUSTOMER): 50681 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/f1693636-9bcc-4365-a699-b0c199693b8a_20250130T17:20_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I just need to check eligibility for a patient.
[AGENT][NEUTRAL] OK, I can help you with eligibility. Can I get your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. a good call back number is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And do you have your patient's policy number?
[CUSTOMER][NEUTRAL] Yeah it is 025378883.
[AGENT][NEUTRAL] OK, and while I get that pulled up, what's the um provider's office are you calling from?
[CUSTOMER][NEUTRAL] Piedmont urgent care.
[AGENT][NEUTRAL] OK, give me just one moment.
[AGENT][NEUTRAL] OK, can you verify the patient's name and date of birth for me?
[CUSTOMER][NEUTRAL] Yes, it's [PII] if I'm saying that correctly.
[AGENT][NEUTRAL] And what's his date of birth?
[CUSTOMER][NEUTRAL] Oh yes, sorry, [PII].
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] OK, so I'm showing that this policy was effective on [PII]. It is still currently active and this is a limited benefit indemnity plan, um, so it's kind of like a
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just for example, like it's kind of like a supplemental plan, so benefits are limited, um, it's not major medical.
[CUSTOMER][NEUTRAL] OK, so does he have a copay or anything?
[AGENT][NEUTRAL] No, no co-pay, no co-insurance, no deductible for this policy top. Um, let's see.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Let me double check benefits here.
[CUSTOMER][POSITIVE] OK sounds good I'll leave it over.
[AGENT][NEUTRAL] He does have outpatient sickness benefits. So if he's there due to a sickness, which I'm making the assumption that he is, but um there is coverage for outpatient sickness.
[CUSTOMER][NEUTRAL] And what, what is that coverage? Is it a copay or deductible?
[AGENT][NEUTRAL] Um, it's so the coverage is actually the benefit amount that we will pay per visit and um that is $75 per day. Um, of course I can't guarantee payment since we don't have a claim on hand that's just the verification of what his policy benefits state.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Yeah, of course. Do you need anything else, [PII]?
[CUSTOMER][NEUTRAL] No, that was it
[AGENT][POSITIVE] OK, well have a great day and thanks for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.