AccountId: 011433970860
ContactId: 361b7b1b-647b-4df3-a7c5-527c1cabdeb0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169160 ms
Total Talk Time (AGENT): 69481 ms
Total Talk Time (CUSTOMER): 58209 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/361b7b1b-647b-4df3-a7c5-527c1cabdeb0_20250404T12:09_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. Uh, my name is [PII]. I'm calling from Ortho now. I was calling to verify if this policy covers the primary's urgent care call please.
[AGENT][NEUTRAL] OK, [PII], do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII]. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02424712 ML8.
[AGENT][POSITIVE] Thank you, [PII]. Hold on one moment, please.
[AGENT][NEUTRAL] And the patient's name.
[CUSTOMER][NEUTRAL] Yeah, it's flying through here.
[AGENT][NEUTRAL] And the date of birth
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you wanted to know if outpatient was covered?
[CUSTOMER][NEUTRAL] Um, if the policy covers their urgent care co-pay from the primary insurance.
[AGENT][NEUTRAL] OK, I can help you with that. The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] This policy coordinates with the primary insurance. We only pick up their deductible, co-pay, or co-insurance for outpatient. We'll pay up to $4000 per calendar year.
[AGENT][NEUTRAL] I mean, 4500. I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and.
[CUSTOMER][NEUTRAL] He still has available for to cover, to be covered.
[AGENT][NEUTRAL] Hold on, just hold on just a moment. I'll check for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yes, ma'am. He hasn't used anything for this year.
[CUSTOMER][NEUTRAL] OK perfect do you have a reference number?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Can you tell me your name again? sorry.
[AGENT][NEUTRAL] It is [PII]
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][POSITIVE] You too thank you bye.
[AGENT][POSITIVE] Thank you. Bye bye.