AccountId: 011433970860
ContactId: 420bcdb9-d8f7-4edd-b122-847aa04599bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195419 ms
Total Talk Time (AGENT): 93107 ms
Total Talk Time (CUSTOMER): 142449 ms
Interruptions: 9
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/420bcdb9-d8f7-4edd-b122-847aa04599bf_20250110T13:22_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, I'm looking to see the benefits of a patient the date of birth again? Say yes or press one. My name is [PII]. I'm a provider. What would you like? Yeah, yes, that's my name. Please say or enter the patients at the ID. Um.
[AGENT][POSITIVE] OK, I can help you with your name.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Did, did you say [PII]?
[AGENT][NEUTRAL] OK, and what's the policy number for the patient, [PII]?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] 01608849 M as in Mike L as in Lima and 8.
[AGENT][NEUTRAL] OK, what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. 1 moment please. The patient is Laura. [PII] correct? Say yes or press 1. No. Yes.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] To receive the information via fax, say have it faxed or press 2.
[AGENT][NEUTRAL] Can you repeat that policy number? I think I have one too many.
[CUSTOMER][NEUTRAL] 01608849 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you, got it.
[CUSTOMER][NEUTRAL] This is.
[AGENT][NEUTRAL] And patient is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, showing a policy effective date of [PII], the policy is active at this time and you're checking benefits, right?
[CUSTOMER][NEUTRAL] The patient's original effective date is June.
[AGENT][NEUTRAL] Is this for service in an office setting?
[CUSTOMER][NEUTRAL] 24 yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The group number is 835-425-01000003.
[AGENT][NEUTRAL] All right. So under this policy, the, the physician's visit fee is not covered. Um, there is an, a treatment writer, so if there's covered treatment during the visit, those items can be considered under the outpatient benefit.
[CUSTOMER][NEUTRAL] Be details
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You put details for the yes or no.
[AGENT][NEUTRAL] So was it for the doctor's office visit or is it? OK, so that is not covered under the policy?
[CUSTOMER][NEUTRAL] I can help you with, say yes or press one. nothing in the doctor's office?
[AGENT][NEUTRAL] Covered treatment, but the copay for the physician's visit is not.
[CUSTOMER][NEUTRAL] OK, what about like surgery, not surgery, sorry, um, ultrasound.
[AGENT][NEUTRAL] OK, that would be considered
[AGENT][NEUTRAL] Mhm. That will be considered a form of treatment, uh, which can be considered under the outpatient benefit. That benefit is up to $1000. That's per calendar day.
[CUSTOMER][NEUTRAL] To us.
[CUSTOMER][NEUTRAL] On the line actually.
[CUSTOMER][NEUTRAL] OK, please hold while I.
[AGENT][NEUTRAL] And any information provided is verification, not a guarantee of payment. And did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] No, um, may I have a reference number? How do I.
[AGENT][NEUTRAL] Uh-huh, you'll use my name in today's date as your reference. [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][NEUTRAL] First initial last name is [PII].
[CUSTOMER][POSITIVE] Got it thank you very much, [PII].
[AGENT][POSITIVE] Alrighty thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] You as well bye bye.