AccountId: 011433970860
ContactId: 0c10fe8d-83d6-48f8-bb89-e75c97cf0bb8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180149 ms
Total Talk Time (AGENT): 70192 ms
Total Talk Time (CUSTOMER): 80814 ms
Interruptions: 0
Overall Sentiment: AGENT=2.8, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/0c10fe8d-83d6-48f8-bb89-e75c97cf0bb8_20250604T19:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi, So, I'm calling from Doctor [PII]'s office. I need to go over benefits on a patient's gap plan.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits and may I have your name?
[CUSTOMER][NEUTRAL] It's [PII], that's [PII]
[AGENT][NEUTRAL] OK. Thank you, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes hi.
[CUSTOMER][NEUTRAL] 02563214 ML 8.
[CUSTOMER][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so I'm gonna go
[CUSTOMER][NEUTRAL] Yeah, I'm gonna just go by what you gave me and then, um, and that's it. I already put down what you gave me and your reference number and that the patient needs an authorization or a referral. So I'll let the patient be aware of that when it comes out. So 25% co-insurance for all services done here and he needs the referral and he can only be seen here in the [PII] for emergency services like you told me. So all that is there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that's all thank you thank you for clarifying that.
[CUSTOMER][POSITIVE] All right, I appreciate it.
[CUSTOMER][NEUTRAL] Likewise bye bye.
[CUSTOMER][POSITIVE] Yes, hi, I'm sorry about that where were we at?
[AGENT][NEUTRAL] Um, um, I need the name and date of birth of the patient.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure, [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you, Ms. [PII]. And what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] So he has a deductible on his primary plan. Any services rendered in the doctor's office, such as a biopsy, he will be responsible for that. So does this gap plan cover that?
[AGENT][NEUTRAL] OK. Let me get benefits, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. This is a secondary supplemental plan to the major medical. This one does have office treatment benefits, so that is an additional benefit that is for any treatment or any service when you're in the office, and that's subject to the outpatient maximum. The outpatient maximum amount is, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that will be 6000 per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK, so that he does have benefits for procedures that may be rendered in the doctor's office.
[AGENT][NEUTRAL] Correct. We do cover the procedures done in the office. The only thing we do not cover is the office visit, the co-payment for the office visit. That's the only thing that is not covered, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK great all right great.
[CUSTOMER][NEUTRAL] So then um the reference number will be your name [PII] and today's date.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][POSITIVE] All right great thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today? You're welcome. Have a good day, Miss [PII].
[CUSTOMER][POSITIVE] Bye bye thank you.
[CUSTOMER][POSITIVE] No that's all thanks all right you too bye bye.
[AGENT][POSITIVE] You're welcome. Thank you.