AccountId: 011433970860
ContactId: 41911f37-80e3-4d0e-a855-b167177b18c3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 133259 ms
Total Talk Time (AGENT): 60658 ms
Total Talk Time (CUSTOMER): 48260 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/41911f37-80e3-4d0e-a855-b167177b18c3_20250127T20:25_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from medical specialist of Palm Beaches. I'm calling today to verify benefits for specialist office visit, please.
[AGENT][NEUTRAL] I can help you. And you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[AGENT][NEUTRAL] OK, and what's the policy number and ID?
[CUSTOMER][NEUTRAL] It is 02503073.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for that information, [PII]. So we're checking eligibility and then office visit benefit.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Alright, so I'm showing an effective date of [PII] policy active at this time and let me pull up the benefits and I can provide that information to you.
[AGENT][NEUTRAL] So,
[AGENT][NEGATIVE] I'm showing that the physician's office visit co-pay is not covered.
[AGENT][NEUTRAL] But there is um a treatment writer if there's, or if there is other treatment, covered treatment in the physician's office, those items can be considered under the outpatient benefit.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] But the copay is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK. So for, for specialist office visit, is it covered?
[AGENT][NEUTRAL] The physician's office fee is not covered.
[CUSTOMER][NEUTRAL] Not. OK. OK. So if the patient is having like a diagnostic testing then this specialist office, it will be covered.
[AGENT][NEUTRAL] It can be considered. It will be treatment, yes.
[CUSTOMER][NEUTRAL] It can.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, OK. OK, thank you so much.
[AGENT][NEUTRAL] All right. Anything else I can assist with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Alrighty, thanks for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye