AccountId: 011433970860
ContactId: 03d0822d-926e-4ecb-8911-198307e46622
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254710 ms
Total Talk Time (AGENT): 100419 ms
Total Talk Time (CUSTOMER): 85837 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/03d0822d-926e-4ecb-8911-198307e46622_20250403T13:02_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Um, hi, [PII]. I am calling from a physician's office and was wanting to check and see a patient's benefits. She has you guys a secondary, so I'm wanting to see um what kind of coverage she has.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] Um, my first name is [PII], and I'm calling from ENT and Allergy Associates of Florida.
[AGENT][NEUTRAL] OK. And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Sure, [PII] and that's a direct line.
[AGENT][NEUTRAL] Thank you, [PII]. And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, so, well.
[CUSTOMER][NEUTRAL] Let me look here. Let me pull her back up.
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 534 57 ML 7
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Are you actually still there?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, when I told you ML 7, that was actually for the in hospitals, it's actually ML8 for outpatient benefits.
[AGENT][NEUTRAL] That's, that's fine. We don't even go by that. That's just the product name. It stops at, the policy number stops at the 7.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] So it doesn't matter, but that's OK.
[CUSTOMER][POSITIVE] Oh, OK, thank you.
[AGENT][NEUTRAL] And what's that patient's name?
[CUSTOMER][NEUTRAL] Um, let's see here.
[CUSTOMER][NEUTRAL] I'm not sure if you pronounce it. [PII] and last name is [PII]
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Thank you, [PII]. And you were just needing benefits?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. I can give those to you. Is it for outpatient, inpatient or doctor's office?
[CUSTOMER][NEUTRAL] It's for a specialist doctor's office.
[AGENT][NEUTRAL] OK, the effective date is [PII]. The policy is active.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] This policy does not cover office visits.
[AGENT][NEUTRAL] But it does cover if they have services done in a doctor's office. It just doesn't cover the office visit itself.
[CUSTOMER][NEUTRAL] That will cover like procedures or whatever in office.
[AGENT][NEUTRAL] Right, like X-rays, injections.
[AGENT][NEUTRAL] If they have any services done in a doctor's office, it's gonna fall under their outpatient benefit and this policy coordinates with the primary insurance. Whatever the primary applies to their deductible, co-pay or co-insurance will pay up to $500 per calendar day.
[AGENT][NEUTRAL] And any benefits given over the phone is not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] Um, do you guys cover her deductible up to $500 per day?
[AGENT][NEUTRAL] Calendar day, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Covers.
[AGENT][NEGATIVE] It just doesn't cover the office visit.
[CUSTOMER][NEUTRAL] OK, and can I get a reference number for the call from you?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] I think that is it. I appreciate your help. Thank you.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.