AccountId: 011433970860
ContactId: 0cabd964-7cdd-4603-85df-968a9fac6d12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 131660 ms
Total Talk Time (AGENT): 77779 ms
Total Talk Time (CUSTOMER): 41997 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/0cabd964-7cdd-4603-85df-968a9fac6d12_20250403T13:08_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], my name is [PII]. I'm with West Wilson Family Practice, and I'm calling to check um benefits and eligibility on a patient that's here.
[AGENT][NEUTRAL] I can help with benefits and eligibility. Um, [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] It is 02519727.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Thank you. While I'm looking that up, if I could have a callback, a, a um callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] I appreciate that. Thank you. So the policy went into effect on [PII]. It is active. Um, this is a secondary or gap insurance. It's going to pick up the deductible, co-payment or co-insurance from the major medical. Now for outpatient, uh, benefits, which includes uh treatment within a physician's office, um, ambulatory services, outpatient hospital, we'll pick up the deductible, co-payment or co-insurance per calendar year up to $2,025.
[AGENT][NEUTRAL] That's just the verification of the benefits, not a guarantee of payment. Now, is there anything in particular that I could help you with? Maybe any particular benefits that you might need to know about?
[CUSTOMER][NEUTRAL] This is just uh a regular office visit at her doctor at her PCP's office.
[AGENT][NEUTRAL] I understand. Now, the treatment within the physician's office will be covered, but the office visit co-pay will not. So, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's uh the, that benefit that we just talked about, that will be for the treatment, but not for the uh um.
[AGENT][NEGATIVE] Not for the office visit.
[AGENT][NEUTRAL] Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] OK, but
[CUSTOMER][NEUTRAL] Are they not no sweetheart, I think you've covered everything. Um, let's see, um, do you have a reference number for this?
[AGENT][NEUTRAL] Well, it's my name, uh, which is [PII] and today's date, and the first letter of my last name is [PII].
[CUSTOMER][POSITIVE] All right sweetheart, thank you so much you have a good rest of the day.
[AGENT][POSITIVE] Mhm. Thanks for contacting if you have a good day.