AccountId: 011433970860
ContactId: 41f06e03-48af-4f61-b4bf-78ffd7585133
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284649 ms
Total Talk Time (AGENT): 89002 ms
Total Talk Time (CUSTOMER): 45454 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/41f06e03-48af-4f61-b4bf-78ffd7585133_20250306T14:04_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes calling to get benefit information.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] My name's [PII] calling from the provider.
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, 02456697.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what was the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And his date of birth? Her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], and you were just needing benefits.
[CUSTOMER][NEUTRAL] Yeah, for a specialist office visit with uh X-rays done in the office and a minor procedure possibly.
[AGENT][NEUTRAL] OK, hold on one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on just a moment. I'm looking it up for you. Hold on one moment.
[CUSTOMER][POSITIVE] Sure, no problem.
[AGENT][NEUTRAL] OK. Office visit, the actual office visit itself is not covered, but the X-rays would be covered, um.
[AGENT][NEUTRAL] Under the outpatient benefit and any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] And let me see what the maximum is just a moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's $6000 is the maximum.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And hold on just a moment, let me see if it's um calendar year or.
[AGENT][NEUTRAL] Policy year.
[AGENT][NEUTRAL] I apologize.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] It's per calendar year, 6000 per calendar year, and it coordinates with the primary, so whatever they primary applies to their deductible copay or co-insurance only will pay up to that 6000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so but anything with the office visit is not covered.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, great. OK, that's all I needed to know.
[AGENT][POSITIVE] Thank you, [PII], for calling APO. You have a good day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.