AccountId: 011433970860
ContactId: 3beb4cd0-5083-4efe-a293-9d6aa66a81d6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240229 ms
Total Talk Time (AGENT): 88152 ms
Total Talk Time (CUSTOMER): 84824 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/3beb4cd0-5083-4efe-a293-9d6aa66a81d6_20250321T20:02_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. Um, um, my name is [PII]. I'm calling from Doctor [PII]'s office. I would just like to get benefits for one of our patients.
[AGENT][NEUTRAL] OK. How do you spell your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have a callback?
[CUSTOMER][NEUTRAL] Can I have your initial, [PII]?
[AGENT][NEUTRAL] [PII], and it's spelled [PII]
[CUSTOMER][NEUTRAL] Thank you. My callback number is [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] 01960246 8.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's that patient's name?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you were just needing benefits?
[CUSTOMER][NEUTRAL] Yes, I like to know if specialist office visit is covered under the plan.
[AGENT][NEUTRAL] OK, I can help you with that. Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] No, ma'am, office visits are not covered, but if they have any services done in a doctor's office, now the services would be covered, but not the actual office visit itself.
[CUSTOMER][NEUTRAL] Oh, how much is the outpatient benefit maximum?
[AGENT][NEUTRAL] Any benefits given over the phones, not a guarantee of payment. We pay for outpatient up to $200 per calendar day and it coordinates with the primary insurance, whatever the primary applies to their deductible, co-pay or co-insurance only.
[CUSTOMER][NEUTRAL] So it's $300 per day.
[AGENT][NEUTRAL] 200.
[CUSTOMER][NEUTRAL] That's the outpatient benefit maximum.
[AGENT][NEUTRAL] 200
[CUSTOMER][NEGATIVE] You're cutting in and out. I don't understand. I can.
[AGENT][NEUTRAL] It is $200.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes, 22WO 20.
[CUSTOMER][NEUTRAL] 20
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Um, $200 per calendar day.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] When is the effective date of the plan?
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh, do you have a group number?
[AGENT][NEUTRAL] 19993.
[CUSTOMER][NEUTRAL] 19993.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh, is this an HMO, PPO indemnity?
[AGENT][NEUTRAL] This is just a gap policy coordinates with the primary.
[CUSTOMER][NEUTRAL] Got it. What's the reference number for this call?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] All right, that will be all for today. Thank you so much, [PII].
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][POSITIVE] You too bye bye have a happy weekend.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.