AccountId: 011433970860
ContactId: 493080fa-6a13-4d07-9930-8f5c7ce4df18
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 456760 ms
Total Talk Time (AGENT): 96509 ms
Total Talk Time (CUSTOMER): 183039 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/493080fa-6a13-4d07-9930-8f5c7ce4df18_20250407T20:29_UTC.wav
--------------------------------------------
[CUSTOMER][NEGATIVE] No, no.
[AGENT][POSITIVE] Thanks for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from E Doctors of South Florida. Um, I have a question about a patient who's currently here. Um, we wanted to know what the, the gap would cover for them for this visit.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Um, what was your name and a good callback number?
[CUSTOMER][NEUTRAL] Um, what was your name
[CUSTOMER][NEUTRAL] [PII] phone number is [PII].
[AGENT][NEUTRAL] Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, it's um let me see.
[CUSTOMER][NEUTRAL] 115493.
[AGENT][NEUTRAL] Um, you have the patient names.
[CUSTOMER][NEUTRAL] Patient's name is um.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, [PII], um, do you want the insured, the insured person, is that what you're asking for?
[AGENT][NEUTRAL] Is that
[AGENT][POSITIVE] Yes, that'd be great.
[CUSTOMER][NEUTRAL] Or the patient was currently the insured is [PII].
[AGENT][NEUTRAL] How do you spell the last name?
[CUSTOMER][NEUTRAL] [PII] Could I have a company up before queli car please.
[AGENT][NEUTRAL] And what was the first name? [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] No oh OK.
[AGENT][NEUTRAL] OK, and then who is the patient and the date of birth?
[CUSTOMER][NEUTRAL] The patient is [PII], which is [PII]
[CUSTOMER][NEUTRAL] And then their last name is [PII], which is [PII]
[CUSTOMER][NEUTRAL] And they have the uh same last name as the insured, which is [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And then like what type of benefits were you needing?
[CUSTOMER][NEUTRAL] Um, we would just wanted to know what this patient, um, has covered with us. Do you need our tax ID or our MPI? No, no.
[AGENT][NEUTRAL] Um, no, but what, what type of benefits will you, like, are you a doctor's office or what type of benefits are you rendering?
[CUSTOMER][NEUTRAL] No, I'm sorry?
[AGENT][NEUTRAL] What type of benefits are you rendering? Is this for a physician's office visit or?
[CUSTOMER][NEUTRAL] See you.
[CUSTOMER][NEUTRAL] Um, it's for a specialist visit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, one moment, hold up.
[AGENT][NEUTRAL] OK, so this is not a guarantee of payment. It's a basic outline of the policy.
[AGENT][NEUTRAL] Um, under this policy, they have a $7900 calendar benefit.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] So, so, uh huh, so would it cover like their testing or something or the co-pay?
[AGENT][NEUTRAL] So the co-pay, it will cover up to $25 per visit.
[CUSTOMER][NEUTRAL] I I.
[AGENT][NEUTRAL] And this is after the primary insurance has processed the claim.
[AGENT][NEUTRAL] So whoever
[CUSTOMER][NEUTRAL] So it will cover $25 from each visit, OK.
[AGENT][NEUTRAL] Yes, but we'll need the primary explanation of benefits when you file the claim.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] To show what they paid.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Under that's for just a regular office visit for specialists, it'll pay up to $50 per visit, maximum of 4 visits per calendar year.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] secure slavia in a cure cuatro visa.
[CUSTOMER][NEUTRAL] Select.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You guys only pay pay copay or you pay testing as well?
[AGENT][NEUTRAL] Uh, we will pay, uh, treatment, procedures and treatment in the office up to that 7900. And that again is after primary insurance is paid.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then the $25 what is that for?
[AGENT][NEUTRAL] That'd be for like primary physician, not a specialist.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Like a PCP or general practitioner.
[CUSTOMER][NEUTRAL] So you guys cover up OK.
[CUSTOMER][NEUTRAL] Miss
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, are you still there?