AccountId: 011433970860
ContactId: 250e30d4-80c5-417e-b200-c65fa193087b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460250 ms
Total Talk Time (AGENT): 218449 ms
Total Talk Time (CUSTOMER): 193396 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/250e30d4-80c5-417e-b200-c65fa193087b_20250331T14:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII], good morning, um, just have some basic questions um on, I'm kinda, I'm new to the policy and I'm getting ready to use it, so, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I can
[CUSTOMER][POSITIVE] And so I, you know, I'm a commer, go ahead.
[AGENT][NEUTRAL] I was gonna tell you I can help you with your questions, Mr. [PII].
[CUSTOMER][POSITIVE] OK, awesome awesome um so you know I'm a truck, a commercial truck driver. I drive to the [PII] and so I called my doctor. I said I won't be, you know, back until mid May and, and talked to their office. They said, well, he can do a telemed visit, you know, wellness visit so I can get my prescriptions renewed and stuff like that.
[CUSTOMER][NEUTRAL] Um, I guess my question is, is, so, um, I would pay them and then put in a wellness claim, is that how that works?
[AGENT][NEUTRAL] Yes, sir, you can do that. um, [PII], can I get your policy number and let me pull that up and verify your policy real quick?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's 02579881.
[AGENT][NEUTRAL] OK, let me look that up real quick, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number and email address that we have on the policy for you, sir?
[CUSTOMER][NEUTRAL] Alright, it's [PII], um, phone number [PII]. Email [PII] [PII].
[AGENT][POSITIVE] OK. Thank you so much. I appreciate you verifying your policy. Let me check real quick and see if you have um Telemed on your policy for your benefits.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK. I'm gonna need to completely pull up the policy. If you don't mind, I'm gonna need to pull that in and it's gonna have to load so that I can read it and see, cause I'd hate for you to go and do that and then it not be covered, uh, so we wanna check first, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, and then I this is a secondary of that question is my, my son [PII] is on that policy. Um, he's in high school and his and his mom wants to take him, you know, to get a, he, well, he needs a doctor checkup, you know, um, and so I just wanted to see if that will work as well, but he would go in person, you know, she would take him in person. He's, he's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK. All right. I'll look at that for you too, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it does have um telemed for your policy.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And it does state this, that physician's office does not include a freestanding outpatient surgery center, hospital emergency room, hospital outpatient facility, or a physical therapy facility or urgent care. So it does have to be done in the telemed part through the physician's office.
[CUSTOMER][NEUTRAL] Right, and that's what he would do, yeah.
[AGENT][NEUTRAL] OK, yes. Um, and then on your benefits for office visits, let me look at that for you so you know what those are, OK? And this is just to verify your benefits. It's not a guarantee of payment. Uh, we have.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, so you have outpatient.
[AGENT][NEUTRAL] Uh, accident or sickness treatment in a physician's office that pays $75.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you know he's, he's, I know he's looking for some blood work because it's been a while since I've given him blood work, you know, and that's associated with the prescriptions obviously. So, you know, does that, does that work as well? I mean, if, if I went to uh.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You know, some, I stopped somewhere here in the country at one of those uh.
[CUSTOMER][NEUTRAL] Dude I can't remember, you know, the, the, the, the big companies where you go in and do your blood work and then they could send it with will that, will that work with the with the policy, um, how.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Let me see, let me see if it, um, it depends on.
[AGENT][NEUTRAL] When the claim is sent in.
[AGENT][NEUTRAL] They'll have diagnosis codes and procedure codes on there for what they did. And so it all depends on what they send in for the diagnosis codes and procedure codes, why they did the blood work.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] And you know it's, it's something that could wait because I'm going home in mid May you know I can go, you know, and, and get it done there and but the answer would still be the same correct?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Right. It'd still be the same. We'd have to get the, the claim in and see what the charges were and see why. So the diagnosis code is the why we're doing the blood work and then the procedure code is what we did. So those will have to be that'll have to be turned in for us to be able to um
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] Review and exam the claim.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there any
[CUSTOMER][NEUTRAL] And then and then what about uh my yeah my son.
[AGENT][NEUTRAL] Is there any other questions you may have?
[CUSTOMER][NEUTRAL] Yeah, you know, my, like I was saying, my, my son [PII], so that will work if, if.
[CUSTOMER][POSITIVE] Um, he can go in and just get a checkup and everything because he plays sports and stuff like that.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir. You do have office visits for outpatient sickness or accident. So, yes, he can go in into the doctor's office and I do see that he is on the policy with you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and then, so basically the.
[CUSTOMER][NEUTRAL] Mom would turn his mom would turn that in if she paid for it and then I would turn in the claim. I, you know, she has all this information. It's just, you know, I wanna make sure I relay it correctly to her so she knows, you know, and then we, we get, we get a basically a, a like the itemized bill from the office.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Mhm. Yes, sir, the itemized statement.
[CUSTOMER][NEUTRAL] Or whatever
[AGENT][NEUTRAL] Now, if the facility that you're going to is willing to file the claim for you, then all you have to do is just give them your card and it has the information on there and they can file the claim for you and they can even call in and verify your benefits if they need to, if they're willing to do that for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Nice. OK.
[CUSTOMER][NEUTRAL] OK great all right yeah no that was it just uh just a basic understanding on it because uh.
[CUSTOMER][POSITIVE] So, OK, that sounds good I appreciate your time.
[AGENT][POSITIVE] You're very welcome, [PII]. I hope you'd be safe on the road. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that's it for today have a good one.
[AGENT][POSITIVE] OK, well you have a wonderful day and thank you for calling APL sir.
[CUSTOMER][POSITIVE] Thanks bye now.
[AGENT][NEUTRAL] Bye-bye.