AccountId: 011433970860
ContactId: 245d2bc0-85ce-419b-8c0e-e2bd06d26f30
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 389040 ms
Total Talk Time (AGENT): 116586 ms
Total Talk Time (CUSTOMER): 61300 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/245d2bc0-85ce-419b-8c0e-e2bd06d26f30_20250129T18:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, um, this is [PII]. I'm calling from Doctor [PII]'s office. I need to go with benefits for patients gap plan.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with benefits and can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, that would be um [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what's Ms. [PII]'s policy number?
[CUSTOMER][NEUTRAL] 1480279 ML8
[AGENT][NEUTRAL] OK, let me look her up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does she have a new policy number because I've, I've been noticing a lot of these plans with the APL have new policy numbers this year.
[AGENT][POSITIVE] Right. Uh, I'm showing that this policy number is still good.
[AGENT][NEUTRAL] Um, it's been in effect since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And this is just to verify her coverage it's not a guarantee of payment. She does have, you're correct, a supplemental insurance policy, a gap insurance that's billed secondary to her primary, and it helps with deductible, co-pay and co-insurance.
[AGENT][NEUTRAL] She has an inpatient benefit amount of $4000 per calendar year and then she has an outpatient benefit amount of $500 per calendar day.
[CUSTOMER][NEUTRAL] OK, so then, um, benefits that are.
[CUSTOMER][NEUTRAL] Uh, procedures that are rendered in the doctor's office are covered with this plan.
[AGENT][NEUTRAL] Let me check when we pull her policy up real quick and see if she has office visits.
[AGENT][NEUTRAL] It's gonna be just a moment while the computer pulls in the policy for me so I can read it.
[AGENT][NEUTRAL] It's searching for the policy now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna take me just a second while I read the policy and see what it says about office visits for you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Right, they don't cause it doesn't cover the offices, it covers the procedures.
[AGENT][NEUTRAL] Right, I wanna read the policy and make sure.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] It states that because some of these policies do have office visits and I wanna make sure that hers does not.
[AGENT][NEUTRAL] It says physician's office on her policy.
[AGENT][NEUTRAL] Um, and the physician office visit fee are both covered on her policy.
[AGENT][NEUTRAL] For sickness or injury.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Um, so how much do they cover? Up to 5000?
[AGENT][NEUTRAL] Right, that was her um benefit amount for uh for outpatient.
[CUSTOMER][NEUTRAL] OK, so may I have a reference number for the call?
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[AGENT][NEUTRAL] It's a [PII]
[CUSTOMER][NEUTRAL] Why? OK.
[CUSTOMER][POSITIVE] All right thank you bye bye.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][POSITIVE] You're very welcome, [PII]. You have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] You too alright bye bye.