AccountId: 011433970860
ContactId: f60e26d3-3295-4aea-b675-72c679d3a522
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 496589 ms
Total Talk Time (AGENT): 170599 ms
Total Talk Time (CUSTOMER): 154795 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/f60e26d3-3295-4aea-b675-72c679d3a522_20250305T15:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling for benefits for patients. um, it'll be a specialist in office visit.
[AGENT][NEUTRAL] OK, and what's your name, ma'am?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And what number [PII] and a good phone number in case we're disconnected.
[CUSTOMER][NEUTRAL] Did you say tax ID number?
[AGENT][NEUTRAL] Your, the policy number for the patient.
[CUSTOMER][NEUTRAL] Oh, policy number, OK, that would be, yeah, uh 02273102 ML8.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Once again.
[AGENT][NEUTRAL] I'm pulling up the information.
[CUSTOMER][NEUTRAL] Pro
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] I'm almost there system is a little slow.
[CUSTOMER][NEUTRAL] Yeah, on our end too, hm.
[AGENT][NEUTRAL] And what's the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Hold on, I moved out of there.
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me give you the current policy number.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] It's 259.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3156.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] Yes, let's see.
[CUSTOMER][NEUTRAL] 259-315-6
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And this policy became effective [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] It's current.
[AGENT][NEUTRAL] It is current.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me look for office visits. So now under this policy.
[AGENT][NEUTRAL] The uh office visit fee is not covered, but I do show a treatment rider so if there's covered treatment during the course of the the visit then the items can be considered.
[CUSTOMER][NEUTRAL] OK, so for instance if they do an ultrasound in the office, OK, what would that benefit be?
[AGENT][NEUTRAL] Uh, treatment in the office?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm not
[CUSTOMER][NEUTRAL] Jesus Christ
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Not really.
[AGENT][NEUTRAL] So let's see that's gonna be considered under the cover treatment can be considered under the outpatient um benefit [PII] which is up to $1000 per calendar day.
[CUSTOMER][NEUTRAL] Per day OK.
[AGENT][POSITIVE] So it's a, so it's a daily benefit. I think that's pretty good.
[CUSTOMER][NEUTRAL] Yeah it sure is.
[AGENT][NEUTRAL] Isn't it?
[CUSTOMER][POSITIVE] Awesome, OK, cool, so $1000 per day, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh huh, up to 1000 up to 1000 per calendar day and yeah, and of course information provided is verification, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Up to 1000.
[CUSTOMER][NEUTRAL] Mhm, OK, I'm trying to think if that's all now I was trying to register to get benefits online and it says patient account number you wouldn't happen to have that, would you?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So you can't verify eligibility and benefits online that is used for the provider to check claim status and the uh huh and so when you go to create that that account the patient account number is going to be the claim number that's assigned to the claim by your office.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so it's, it's, it, it doesn't this, uh, website or the service doesn't check eligibility and benefits.
[AGENT][NEUTRAL] Yeah you yeah you can't check that information on the website that's just for the provider to check the claim status so when you create that account, if you don't have a claim that's already been submitted and processed by us, then you're not gonna be able to access it because it's asking you for the information on your claim that you'll eventually send us OK.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, no worries then, um, yeah, no, totally, totally, I know there was something else, um.
[AGENT][NEUTRAL] That makes sense.
[CUSTOMER][NEUTRAL] OK, oh, this new ID number now on the card it has like an ML so it doesn't, we no longer have ML.
[AGENT][NEUTRAL] That's fine that's internal anyway, so just give us the numbers, mhm.
[CUSTOMER][NEUTRAL] Anymore is that right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and is it the same group number?
[AGENT][NEUTRAL] Uh, so this is in, let's see.
[CUSTOMER][NEUTRAL] I have 21471.
[AGENT][NEUTRAL] Give me a second.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So this is an individual life policy so there's not gonna be a group number.
[CUSTOMER][NEUTRAL] No group OK and then what is the um.
[AGENT][NEUTRAL] I'm sorry, hold on a second. I just told you something incorrect.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, go ahead, OK.
[AGENT][NEGATIVE] It's not right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You're right. It is 21471.
[CUSTOMER][NEUTRAL] OK, so same.
[AGENT][NEUTRAL] Centurion Restaurant Group.
[CUSTOMER][NEUTRAL] Yeah, or so.
[AGENT][NEUTRAL] Yeah, that's the same so the group their employer is still the same. They just updated or changed to a different policy, which it a new policy number was assigned for that reason.
[CUSTOMER][NEUTRAL] OK, and then just to double check, uh, the claims is that um PO Box 248,950?
[CUSTOMER][NEUTRAL] Oklahoma City, [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Is this alright sounds good. uh, what was your name again? I'm sorry.
[AGENT][NEUTRAL] You're gonna use [PII]
[AGENT][NEUTRAL] First initial of my last name is [PII] as reference for today's call.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right awesome thank you for your help.
[AGENT][POSITIVE] Uh, you're welcome, [PII]. If no other questions, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye.