AccountId: 011433970860
ContactId: 43fe5b38-adf9-462d-9b49-ab7b6b1568c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245639 ms
Total Talk Time (AGENT): 60750 ms
Total Talk Time (CUSTOMER): 143938 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/43fe5b38-adf9-462d-9b49-ab7b6b1568c6_20250312T15:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] Hey sir, it's uh [PII], heck of a nice guy most of the time, but I'm moody today.
[CUSTOMER][NEUTRAL] So how you doing?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm doing, I was doing great, but then it's never easy, you know, it's always the owner's kid has autism or something like that and uh that, you know, and then I have my agent over there at the enrollment and they're asking this question, so.
[CUSTOMER][NEUTRAL] Um, let me just pull up a policy for you because it's, I don't even have a policy because it's a brand new group, so let me just pull up another Medlink 9 Florida, uh, policy for you. Just give me a second. Um, my best call back number because I'm stalling is [PII].
[AGENT][POSITIVE] Thank you, [PII]. I appreciate that.
[CUSTOMER][POSITIVE] Yeah, appreciate you.
[CUSTOMER][NEUTRAL] I already know what the answer is, but I just wanna make sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me look for Meli 9.
[CUSTOMER][NEUTRAL] Oh let me check that.
[CUSTOMER][NEUTRAL] Let me just down download a group detail because I have to give you the person's um date of birth, just bear with me one second.
[AGENT][NEUTRAL] OK. No problem, [PII].
[CUSTOMER][NEUTRAL] Even even though it's for somebody else, alright, so it's gonna be policy number.
[CUSTOMER][NEUTRAL] 2605812
[CUSTOMER][NEUTRAL] And that's going to be for [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And date of birth is tell me when you're ready.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, got it pulled up here, [PII]. So what are
[CUSTOMER][NEUTRAL] Alright, yeah, let me just ask what the question is, so the question is, you ready?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What about behavioral therapy for autism?
[CUSTOMER][NEUTRAL] Is that covered underneath the Medin 9?
[AGENT][NEUTRAL] Behavioral health, let's see.
[CUSTOMER][NEUTRAL] Well, yeah, it says behavior therapy which I don't see on the summary at all.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I was gonna tell my agent no to tell the owner no but I just wanna make sure it's no.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, so under outpatient benefits, it lists physical therapy in a physical therapy office, occupational therapy, speech therapy.
[CUSTOMER][NEUTRAL] Pa
[CUSTOMER][NEUTRAL] Therapy and a physical therapy office.
[CUSTOMER][NEUTRAL] Yeah, there's nothing that says behavioral.
[AGENT][NEUTRAL] And then it
[AGENT][NEUTRAL] No, and then it just has treatment of a mental or emotional disorder performed in a hospital outpatient facility or outpatient psychiatric treatment facility or physician's office.
[CUSTOMER][NEUTRAL] So, and then it just has treatment of a mental or emotional disorder performed in.
[CUSTOMER][NEUTRAL] outpatient facility.
[CUSTOMER][NEUTRAL] Hold on sir, one second. Hey, can I call you back in like 30 seconds? I'm just handling an autism question. Alright, bye.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, I'm back live. So what do you think? You think I might fall underneath the.
[CUSTOMER][NEUTRAL] The mental health or what's it, let me just look at it again treat for mental or emotional disorder. You think it might be treatment of that?
[AGENT][NEUTRAL] Yeah, I mean,
[AGENT][NEUTRAL] It might fall underneath that. I mean, I always advise people when I'm reading from the policy, yeah.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] Yeah, I know to send it and I know same here I got you alright that's what I'll tell her I'll just say there's a gray area it depends on the diagnosis code.
[AGENT][NEUTRAL] Alright, [PII].
[CUSTOMER][POSITIVE] OK all right thanks sir I appreciate you thank you bye.
[AGENT][NEUTRAL] You're welcome. Uh-huh, bye.