AccountId: 011433970860
ContactId: 1ec429e3-9448-4aed-b5bb-8481611e4f33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210440 ms
Total Talk Time (AGENT): 66440 ms
Total Talk Time (CUSTOMER): 80381 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/1ec429e3-9448-4aed-b5bb-8481611e4f33_20250318T21:51_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. I'm calling from Doctor [PII]'s office, and I need to go over benefits for patients gap plan.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility. Um, may I have your first name please?
[CUSTOMER][NEUTRAL] Um, yes, it's [PII], that's [PII]
[AGENT][POSITIVE] And [PII], if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 02419339.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment.
[AGENT][NEUTRAL] I do show the policy is currently active. Effective date is [PII] of.
[AGENT][NEUTRAL] [PII] and are you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] For office surgery, so it would be outpatient, so I need to know if this plan covers procedures in the office.
[AGENT][NEUTRAL] Yes, um, this, that will fall under her outpatient calendar year maximum of $8700. Only thing won't be covered would be the physician's charges.
[CUSTOMER][NEUTRAL] Right, but does she have a deductible with this client that needs to be met first before they cover procedures in the office? Oh now they cover procedures in the office. She doesn't have a deductible anymore.
[AGENT][NEGATIVE] Not with this plan.
[AGENT][NEUTRAL] Let me look at her old policy. This one started on [PII], so let me go back and see if that was what, because she changed policies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][POSITIVE] OK thanks.
[AGENT][NEUTRAL] I'm sorry she had the office rider on the last policy too.
[AGENT][NEUTRAL] But I don't see where she had a deductible.
[CUSTOMER][NEUTRAL] Well, let me go back to her because I was looking at something else, yeah, she had a deductible with the plan.
[CUSTOMER][NEUTRAL] Um, hold on.
[AGENT][NEUTRAL] With us or with her major medical?
[CUSTOMER][NEUTRAL] No, with full let me see something here.
[CUSTOMER][NEGATIVE] Yeah, no deductible
[CUSTOMER][NEUTRAL] Oh, you're right. I was reading somebody else I got crossed over. OK, yeah, so this one did cover procedures in the office. OK, I look at somebody else's, never mind. OK, so she still has that and up to how much did you say?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] $8700.
[CUSTOMER][NEUTRAL] OK, so it went up, yeah, I think so.
[CUSTOMER][NEUTRAL] OK, it doesn't matter, yeah, OK, so she has benefits up until up to 8700. All right, great. May I have a reference number for the call?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] OK great.
[CUSTOMER][POSITIVE] No, that's all thank you all right.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You're welcome bye bye.
[AGENT][NEUTRAL] Bye.