AccountId: 011433970860
ContactId: 3a4a02de-27a3-4f72-bf4b-64d0f592836c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177399 ms
Total Talk Time (AGENT): 57624 ms
Total Talk Time (CUSTOMER): 94674 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/3a4a02de-27a3-4f72-bf4b-64d0f592836c_20250211T13:07_UTC.wav
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[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Thank you for calling APL. This is Ta[PII]How may I help you?
[CUSTOMER][NEUTRAL] Oh hi Ms. Ta[PII]I am calling from a provider office to verify a policy to a specialist office visit.
[AGENT][NEUTRAL] OK, and your name?
[CUSTOMER][NEUTRAL] Si[PII]
[AGENT][NEUTRAL] [PII]nd what's the policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, it is 02538034.
[CUSTOMER][NEUTRAL] M Ma[PII].
[AGENT][NEUTRAL] And what's a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, we are at 30[PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] This is Ma[PII]Date of birth is Ju[PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK, thank you for that and you're checking eligibility and uh benefits for service in a doctor's office?
[CUSTOMER][NEUTRAL] Yes, first the doctor's office usually I come across there's no coverage for the visit, but there's other kind of coverage, so yeah, I'd like to find that out.
[AGENT][NEUTRAL] Showing the policy effective date is Au[PII]Policy is active at this time.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Uh, the office visit co-pay is not covered. Uh, this policy does have a treatment writer, so when covered treatment in the office is performed, it can be considered under the outpatient benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So no coverage for office visit, but the doctor sometimes, if necessary, does an injection or actual surgery at a facility, uh, an ambulatory. Would then there be coverage?
[AGENT][NEUTRAL] Mhm, under the, uh, can be considered under the outpatient benefit of up to $500. That's per calendar year. Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, 500, yes.
[AGENT][NEUTRAL] Per calendar here.
[CUSTOMER][NEUTRAL] OK, up to 500, OK.
[AGENT][NEUTRAL] And of course information provided is verification, not a guarantee.
[AGENT][NEUTRAL] A payment and did you have any other questions Iv[PII]?
[CUSTOMER][NEUTRAL] Right, just to make sure also, uh, the claims address on the card says Ok[PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Beautiful, thank you, Ms. Ta[PII]You have yourself a good rest of the week.
[AGENT][POSITIVE] You're welcome, Ms. Sa[PII]Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.