AccountId: 011433970860
ContactId: 381b0d89-1d88-4c12-8bd7-ddd5dd0cccc2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 152750 ms
Total Talk Time (AGENT): 68310 ms
Total Talk Time (CUSTOMER): 59563 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/381b0d89-1d88-4c12-8bd7-ddd5dd0cccc2_20250103T13:53_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I was just calling to verify, um, sorry, benefits and eligibility for a patient.
[AGENT][NEUTRAL] OK, I can help you. What is your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK. And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] It is 01702708.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And if you can verify the patient's name and date of birth for me?
[CUSTOMER][NEUTRAL] Yes, uh, first name [PII], last name [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information and you said you're checking eligibility and benefits is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Correct, yes, a specialist office. Mhm.
[AGENT][NEUTRAL] OK, OK, so the policy effective date is [PII], currently active at this time, and let me pull up the benefits and I'll be able to provide that information.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] OK, so under this policy, the physician visit fee is not covered. Um, however, there is a treatment writer, so if there's treatment during the course of that visit, covered, cover charges can be considered under the policy.
[CUSTOMER][NEUTRAL] OK. So, OK. So let me just confirm. You said um the visit is not covered, but if there is treatment, then that will be covered?
[AGENT][NEUTRAL] It can be considered if it's covered treatment under the patient's policy.
[CUSTOMER][NEUTRAL] OK, we could.
[CUSTOMER][NEUTRAL] Got it. OK.
[CUSTOMER][NEUTRAL] OK, and that would be it, right? for her benefits?
[AGENT][NEUTRAL] Uh, well, as far as service in a doctor's office, yes.
[CUSTOMER][NEUTRAL] OK, and that's considered for a specialist office visit, correct?
[AGENT][NEUTRAL] A PCP or specialist.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] The physician's visit isn't covered.
[CUSTOMER][POSITIVE] OK, thank you so much and can I get your name please?
[AGENT][NEUTRAL] You'll use my name in today's state as your reference, [PII]. And any other questions, [PII] I could help with today?
[CUSTOMER][POSITIVE] No, that would be it. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome thanks for calling APO have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.