AccountId: 011433970860
ContactId: 530ffe05-9bc1-492c-b2d3-fb00d06b316d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188889 ms
Total Talk Time (AGENT): 116920 ms
Total Talk Time (CUSTOMER): 62130 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/530ffe05-9bc1-492c-b2d3-fb00d06b316d_20250423T21:42_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yes, hi, I'm calling for Doctor [PII]'s office. I need to go with benefits on a patient.
[AGENT][POSITIVE] Yes ma'am. I'll be glad to help you go and give me your name and the member's policy number.
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. That's [PII] Patient's policy number is 02467004ML8.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for all of that information. Now while I'm pulling the policy up, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Alright, thank you for all that information. Now, your patient's name and date of birth today, please, ma'am.
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Alright, thank you for all that information. Looks like [PII] is the insured on this medical supplemental plan, and you did say you had questions about benefits. Is that correct?
[CUSTOMER][NEUTRAL] Yes, she has a deductible with her primary plan, so I need to know if this gap plan will cover procedures that are rendered in the office.
[AGENT][NEUTRAL] OK, what does she have done?
[AGENT][NEUTRAL] Like office visit or treatment?
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] No, the procedure or treatment, does this, does this gap plan have an office writer?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me get that benefit pack pulled up. Let's see what she has.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Alright, now, of course, what we are is her medical supplemental plan. So the only thing that we would pick up and pay on is anything that is applied towards her deductible, co-pay, or co-insurance at her primary insurance carrier for sickness and injury injury only. Nothing routine here is covered no matter what. Now, I do show that this plan.
[AGENT][NEUTRAL] It's covered and active at the moment, but it does look like it's terminating on [PII].
[AGENT][NEUTRAL] But as of today, she's active.
[AGENT][NEUTRAL] But the office treatment benefit is going to be, let's see, well, 0 deductible. She does have office treatment benefit.
[CUSTOMER][NEUTRAL] OK, so procedure engine in the office you would have coverage for?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] If her primary doesn't pay for it? OK.
[AGENT][NEUTRAL] Mhm. As long as she's covered and active.
[CUSTOMER][NEUTRAL] All right, so let me have a rep.
[CUSTOMER][NEUTRAL] Yes, and what's the what's your with the reference number?
[AGENT][NEUTRAL] Well, we don't give reference number, [PII], but you can use my name in today's date, and her max payable per calendar year is $22,500.
[CUSTOMER][NEUTRAL] OK, and um how do you spell your name? [PII]?
[AGENT][POSITIVE] [PII] Yes, ma'am, that is correct, [PII], and is that all I can help you with?
[CUSTOMER][NEUTRAL] it's [PII] or [PII]? How do you spell his name again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] what?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK great alright thank you alright bye bye.
[AGENT][POSITIVE] Alrighty, [PII]. Thank you, ma'am for calling IPO. mhm Bye-bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome bye.