AccountId: 011433970860
ContactId: 2f183592-0566-43ce-bea0-2f3da79d4dd5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290739 ms
Total Talk Time (AGENT): 92771 ms
Total Talk Time (CUSTOMER): 80747 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/2f183592-0566-43ce-bea0-2f3da79d4dd5_20250407T18:18_UTC.wav
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[AGENT][NEUTRAL] Calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Allied Chiropractic, and I'm wondering if you can help me, um, look up benefits for a patient.
[AGENT][NEUTRAL] Sure, I can assist you with that. Can you provide me with the spelling of your name and the callback number?
[CUSTOMER][NEUTRAL] Yes, um [PII]
[CUSTOMER][NEUTRAL] And then phone number is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the policy number of the member that you're calling to verify benefits for today?
[CUSTOMER][NEUTRAL] Um, it is going to be 02586172.
[AGENT][NEUTRAL] Thank you, [PII]. Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, uh, oh my gosh, [PII] and then date of birth [PII].
[AGENT][NEUTRAL] And what benefits are you inquiring about today?
[CUSTOMER][NEUTRAL] Chiropractic care.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the member has um office visit benefit of $100 per visit with 5 visits per calendar year, and this is not a guaranteed benefits just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] But the only thing you're seeing is office visit, correct?
[AGENT][NEUTRAL] Yes, but, you know, the treatment received in a physician's office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do is there a CPT code for the office visit?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Or do you see any?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, because office visit would be like an like for our office it would be like an exam for a new patient or existing patient, but not necessarily chiropractic care. So I just wanted to confirm if you.
[AGENT][NEUTRAL] OK, so let me transfer you to the correct queue because I could just verify benefits but get into detail to it. I'll have to transfer you to the correct queue so they can better assist you. Hold one moment if you don't mind.
[CUSTOMER][NEUTRAL] Thank you. You are on hold.
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Referring.
[AGENT][NEUTRAL] Chiropractor.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey, [PII], how are you doing?
[CUSTOMER][POSITIVE] I'm doing good how are you doing this morning?
[AGENT][NEUTRAL] I'm great, thanks for asking, [PII]. This is [PII]. I have a provider on the phone. She's calling in regards to a policy. Let me know when you're ready for the policy. She wanted to verify, so I was able to verify the the office visits benefits for her. However, she wants to verify if chiropractor is covered under the policy.
[CUSTOMER][NEUTRAL] OK, and what's the policy number?
[AGENT][NEUTRAL] It is 258-617-2. That's 258-61772.
[CUSTOMER][NEUTRAL] OK, and what's the um the lady's name that's calling or the provider that's calling?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, and she's with which office?
[AGENT][NEUTRAL] I forgot, but her callback number is [PII].
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK dokey alright you can go ahead and put through, thank you.
[AGENT][NEUTRAL] Hold one moment.
[AGENT][POSITIVE] Alright, thank you, [PII], have a good one.
[CUSTOMER][POSITIVE] You're welcome, I love.
[AGENT][POSITIVE] Hello [PII]. I'm gonna transfer you over to [PII]. She's gonna better assist you, but thanks for calling APL and you have a great day. Have a good day, [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] Thank you