AccountId: 011433970860
ContactId: f52a7458-e83b-4dfa-a447-e7612744a82c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 365459 ms
Total Talk Time (AGENT): 91630 ms
Total Talk Time (CUSTOMER): 134005 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/f52a7458-e83b-4dfa-a447-e7612744a82c_20250625T19:36_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Uh, my name is [PII] and I'm calling from MPath Care Center on a recorded line for mental or behavioral health benefits. So, could you please help me with that?
[AGENT][POSITIVE] Uh, yes, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] I have a direct line number. Uh, this one is [PII].
[AGENT][NEUTRAL] And the policy number for the patient?
[CUSTOMER][NEUTRAL] OK, it's 026 09025.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK. And then you said for outpatient mental health benefits?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Not a guarantee of payment, basic outline of the policy. Let me get that pulled up. Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It looks like for their benefit, they have 5 visits per calendar year, and it pays a maximum of $75 per visit.
[CUSTOMER][NEUTRAL] OK, you pay only $75 for per digit, right? Only for 5 digits.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So there is no co-pay coinsurance, deductible, or out of pocket, right?
[AGENT][NEUTRAL] Uh, correct, that's just the maximum we pay.
[CUSTOMER][NEUTRAL] OK, and the plan type is the commercial PPO, right?
[AGENT][NEUTRAL] No, it's just a supplemental policy.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] It's supplemental.
[CUSTOMER][NEUTRAL] too much of a payment or maybe.
[AGENT][NEUTRAL] It's like a supplemental policy, it's not a major medical policy.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] Got it, sir. Which one is the network?
[AGENT][NEUTRAL] There's no network.
[CUSTOMER][NEUTRAL] OK. Insurance name is American Public Life, right?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So there may be a network is there I know if I.
[CUSTOMER][NEUTRAL] Let me check if I have the member ID card.
[AGENT][NEUTRAL] There's
[AGENT][NEUTRAL] There's no network associated with it. Um, well, let me make sure. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, please.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Um, they can use multiplan.
[AGENT][NEUTRAL] As the network, but they don't have to, so.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So could you please check the provider is in network with this one or not? Because if I'm not sure we are in network or not.
[AGENT][NEUTRAL] Uh, you'll, I can give you the website.
[CUSTOMER][NEUTRAL] Uh, if you can reach it.
[AGENT][NEUTRAL] Yeah, I can't check. Um, I don't have access. Uh, there are websites [PII] or I can transfer you over to their number.
[CUSTOMER][NEUTRAL] OK, uh, first I need a little bit more information like what is the group name?
[AGENT][NEUTRAL] Uh group name is.
[AGENT][NEUTRAL] Oxford Global Resources.
[CUSTOMER][NEUTRAL] So OK, and the group number?
[AGENT][NEUTRAL] 70052
[CUSTOMER][NEUTRAL] 70052.
[CUSTOMER][NEUTRAL] And the effective date of this plan, please?
[AGENT][NEUTRAL] Uh, the effective date is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. So what is the mailing address to submit the claims by mail?
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the electronic payer ID?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK OK.
[CUSTOMER][NEUTRAL] And you said your name is [PII], right? [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the first initial of your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII], uh, I need the network status. So please transfer your network department. I want to know the, uh, provide the information also.
[AGENT][NEUTRAL] OK, hold on one moment, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what is the call reference number as well?
[AGENT][NEUTRAL] It's my name and today's date.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][POSITIVE] OK. uh I'll get you transferred right now.
[CUSTOMER][NEUTRAL] Welcome to Benefits in a card.