AccountId: 011433970860
ContactId: 3e7c463d-1b3a-427b-9d73-81340988cd02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181149 ms
Total Talk Time (AGENT): 95853 ms
Total Talk Time (CUSTOMER): 73277 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/3e7c463d-1b3a-427b-9d73-81340988cd02_20250424T12:14_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][POSITIVE] [PII], good morning. How are you doing?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][POSITIVE] I'm doing well. I've got [PII] on the phone. She's calling for benefits on policy number 244.
[CUSTOMER][NEUTRAL] 2090 for [PII] and I verify the information. I've got a callback number if you want it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that number?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII]. Yes, ma'am.
[AGENT][POSITIVE] OK. OK, got it. I'm ready. I'm ready. You're welcome.
[CUSTOMER][NEUTRAL] OK, thank you. Hey, can I, do I, do I get swap when I'm joining the call?
[AGENT][POSITIVE] No, you can actually just leave, put leave call and I'll, and the call will come to me.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII]. Have a great day, OK.
[AGENT][POSITIVE] You're welcome. You too. Bye bye.
[CUSTOMER][NEUTRAL] Girl.
[AGENT][NEUTRAL] Hi, this is [PII]. Can I help you with benefits, uh, [PII]?
[CUSTOMER][NEUTRAL] Uh yes, good morning. I'm calling for benefits to see if it picks up a specialist office visit.
[AGENT][NEUTRAL] OK, let me pull up the policy number. I have 2,442,090.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And it's my understanding that you've already been verified, phone number, um, and let me get you to verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Everything
[CUSTOMER][NEUTRAL] [PII] [PII] is the date of birth.
[AGENT][NEUTRAL] OK, I can barely hear you.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And so we're checking eligibility and then office visit benefit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, I have that information for you. I'm showing an effective date of [PII]. Uh, this policy is active at this time.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Under this policy, the physician's co-pay is not covered, but I do show a treatment writer. So if there's treatment in the office, we can consider covered items under the outpatient benefit.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] And how much is it there?
[AGENT][NEUTRAL] And so was this just for the positions fee?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, all right. Did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Um, what's their maximum on that, on that, the, the treatment?
[AGENT][NEUTRAL] For treatment in the office?
[CUSTOMER][NEUTRAL] Yeah, what is the, the maximum? Is it still 2000?
[AGENT][NEUTRAL] OK, so the treatment and covered treatment in the office is covered under the outpatient benefit which is up to $2000 and that's a per calendar year benefit.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] And of course this is just a verification of coverage. It does not guarantee payment of a claim and I don't show they've used any of the benefit this year.
[CUSTOMER][POSITIVE] OK perfect
[CUSTOMER][POSITIVE] Perfect thank you very much.
[AGENT][NEUTRAL] All right. Anything else I can assist with today, [PII]?
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] That's it
[AGENT][POSITIVE] Alrighty thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.