AccountId: 011433970860
ContactId: 21efd7f8-536e-47aa-bb58-0cca5cf6be1e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161559 ms
Total Talk Time (AGENT): 98407 ms
Total Talk Time (CUSTOMER): 35979 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/21efd7f8-536e-47aa-bb58-0cca5cf6be1e_20250602T14:00_UTC.wav
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[AGENT][NEUTRAL] contacting ATM. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, good morning. My name is [PII]. I'm calling regarding benefits for a patient.
[AGENT][NEUTRAL] I can help with benefits. What is that, uh, policy number, please?
[CUSTOMER][NEUTRAL] Uh, the number is 01611530 ML8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Uh, sure. The number is [PII], no extension.
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII], and it is active. Now you mentioned wanting to know about benefits. Uh, this policy has both in and out of hospital benefits as well as durable medical uh treatment within a physician's office. Is there anything in particular that I could tell you?
[CUSTOMER][NEUTRAL] Uh, yes, I need the specialist office visit benefits.
[AGENT][NEUTRAL] Yes, so what we will do for a special office visit.
[AGENT][NEUTRAL] is that we will pick up the deductibles, co-payment or co-insurance for the treatment or procedures within a physician's office.
[AGENT][NEUTRAL] Up to $1500 per calendar year. Now that's just a verification of those benefits, not a guarantee of payment.
[AGENT][NEUTRAL] But um they do not include the office visit co-pay. So it's treatment within the physician's office.
[AGENT][NEUTRAL] Or um
[AGENT][NEUTRAL] Uh, procedures but not the office visit copay and let me just see how much [PII] has used for the calendar year [PII]. I not sure. I think he may have used all the benefits. I just wanna check really quickly.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] So it looks like [PII] has uh used about $1200 of his $1500 benefits.
[AGENT][NEUTRAL] Again, that's just a verification, not a guaranteed payment but that looks like that's how much she's using.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So it uh the policy does not cover the office visit, right?
[AGENT][NEUTRAL] It does not cover the office, is it? No, ma'am. Uh, it covers the treatment of, of, of the, uh, in the physician's office but not the office of the propane.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. Uh, can I get your name again, please?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Is there anything else at all I can tell you about the policy for?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Uh, no, [PII], that is all. Thank you.
[AGENT][POSITIVE] OK, thanks for contacting AP