AccountId: 011433970860
ContactId: 06777a4d-d14f-43f2-b39a-4a984f17367d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241020 ms
Total Talk Time (AGENT): 98375 ms
Total Talk Time (CUSTOMER): 92651 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/06777a4d-d14f-43f2-b39a-4a984f17367d_20250321T14:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi there, good morning. I'm calling from a provider for um office visit benefit.
[AGENT][NEUTRAL] OK, sure, I can assist you with office visit benefits, and may I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Thank you. And what's the name of the facility you're calling from, Mr. [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, we were given 0255.
[CUSTOMER][NEUTRAL] 911.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] Thank you. And what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], did you ask me for the name?
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, Mr. [PII]. All right, let me check and see if we cover all this. One moment.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] OK, and this is not a guarantee your payment, just a verification of coverage. Uh, this one doesn't have an office visit benefit. It only has an office procedure or office treatment benefit. So we only cover procedures done in the office, but we do not cover the visit itself.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] No office visit. I'm writing it down coverage only office visit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Treatment and um up until how much is covered, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The outpatient maximum is 1000 per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK, 1000. Are you allowed to tell me if it's been exhausted or you're not allowed to tell me?
[AGENT][NEUTRAL] Yeah, I can tell you. Let me check on that, one moment.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] As of today, she has only used $75.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] And where do we send the claims please?
[AGENT][NEUTRAL] Any claims goes to APL or American Public Life, and that's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Oh, you broke up after the last four digits of the zip code. What is it?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK and you said [PII], right?
[AGENT][NEUTRAL] [PII]. Mhm.
[CUSTOMER][POSITIVE] OK, [PII]. OK, beautiful. Thank you. You have a good weekend.
[AGENT][NEUTRAL] You as well, Miss [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, we are good to go.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. Have a good week and a good afternoon. Thank you. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.