AccountId: 011433970860
ContactId: 1ab49fb6-a0c8-4e7e-abb5-a8915fbd6784
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275000 ms
Total Talk Time (AGENT): 124171 ms
Total Talk Time (CUSTOMER): 94218 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/1ab49fb6-a0c8-4e7e-abb5-a8915fbd6784_20250508T18:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from Urology Centers of Alabama. um, I was calling to verify this patient's benefits and to find out if this, if her plan is primary or secondary.
[AGENT][POSITIVE] OK, I can help you with benefits and also um.
[AGENT][NEUTRAL] Whether the policy is primary or secondary, Ms. [PII], what is your callback number, ma'am, just in case the call is dropped.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Certainly [PII].
[AGENT][NEUTRAL] Thank you, and then may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, patient's name is [PII]. Her date of birth is [PII], and her policy number is 02539176.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're very welcome. OK, I do have an active policy for Ms. [PII]. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is, um, it's not a major medical insurance, it's not primary, it's not secondary. Uh, it's a hospital indemnity plan, it's a limited benefit plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] Does it cover um office uh specialty office visits?
[AGENT][NEUTRAL] Let me look on her policy real quick and see.
[AGENT][NEUTRAL] OK, she does have, and this is just to verify her benefits. It's not a guarantee of payment. She does have um physician office visits, outpatient for accident or sickness treatment. She gets 4 visits a year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] It pays $90 per visit.
[CUSTOMER][NEUTRAL] OK. And, and does she have a copay associated?
[AGENT][NEUTRAL] I'm sorry. Wait a minute.
[AGENT][NEUTRAL] No, she doesn't have a copay and I was on the wrong line. I just gave you physical therapy. I'm so sorry. Let me give you the physician office benefit. OK. OK, so physician office visit for outpatient accident or sickness treatment is $150.
[CUSTOMER][POSITIVE] Oh, no worries.
[AGENT][NEUTRAL] Not 90.
[CUSTOMER][NEUTRAL] OK, that's what y'all would pay.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] No, and so she doesn't and so she would not have a copay associated with the visit?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. OK, I got it. And does she have a, um, a limited number of visits for off the office visits?
[AGENT][NEUTRAL] Yes, she gets 4 per calendar year.
[CUSTOMER][NEUTRAL] OK. And do you show how many she's already had this year?
[AGENT][NEUTRAL] Let me check real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If she's used any.
[AGENT][NEUTRAL] She does not have any more visits left for this calendar year.
[CUSTOMER][NEUTRAL] No visits left, so technically y'all would not cover.
[CUSTOMER][NEUTRAL] Any of her
[AGENT][POSITIVE] Correct. Right. She's, yeah, she's maxed out her visits.
[CUSTOMER][NEUTRAL] Visits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, got you, thank you so much for your help I appreciate it.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that's it for now.
[AGENT][POSITIVE] All right. Well, you have a wonderful rest of your week and weekend and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you so much, you too.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Mm bye bye.