AccountId: 011433970860
ContactId: 58146f18-b0fa-4a44-bd2a-a7ee99a9476d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 311959 ms
Total Talk Time (AGENT): 89896 ms
Total Talk Time (CUSTOMER): 68077 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/58146f18-b0fa-4a44-bd2a-a7ee99a9476d_20250321T18:00_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling here from a doctor's office. Um, I just wanna verify, um, the insurance or just see if you guys cover the co-payments X-rays for the, uh, mutual patient.
[AGENT][NEUTRAL] OK, I can uh verify benefits for you, [PII]. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh, yeah, uh, let me know whenever you're ready.
[AGENT][NEUTRAL] Actually, can I get a good call back number before we get that?
[CUSTOMER][NEUTRAL] Yeah 786.
[CUSTOMER][NEUTRAL] 453-266 7.
[AGENT][NEUTRAL] OK, and what's that policy number?
[CUSTOMER][NEUTRAL] It is 02467425.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] and it's [PII].
[AGENT][NEUTRAL] OK, it's not a guarantee of payment, just a basic outline of the policy.
[AGENT][NEUTRAL] Uh, show her effective [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're needing you said office visit benefits?
[CUSTOMER][NEUTRAL] Yeah, I just wanna see if it covers office visits and X-rays.
[AGENT][NEUTRAL] OK, let me look.
[CUSTOMER][NEUTRAL] And any DME
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Will the X-ray be in a physician's office?
[CUSTOMER][NEUTRAL] Uh yeah, it's a specialist office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh let me see here.
[AGENT][NEUTRAL] Just checking her policy, making sure I'm not missing anything.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it does cover durable medical equipment.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Seeing if there's any coverage for the office visit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, can I place you on a brief hold?
[CUSTOMER][POSITIVE] Yeah, that's fine take your time.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding. Yes, so it does look like there is coverage for treatments and procedures performed in the office, just not the actual office visit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and then it does cover durable medical equipment as well. That is a $5000 per covered person per calendar year benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Perfect. Alrighty and then the X-rays, is it covered or no?
[CUSTOMER][NEUTRAL] No, you said no, right? I don't remember.
[AGENT][NEUTRAL] Uh, yes, uh, no, that would be covered, just not the actual office visit charge that part's not covered.
[AGENT][NEUTRAL] So treatments and procedures in the physician's office, durable medical equipment, those things are covered under that 5000.
[CUSTOMER][POSITIVE] Oh OK perfect.
[CUSTOMER][POSITIVE] OK perfect all right perfect all set thank you so much um actually can I have a um.
[CUSTOMER][NEUTRAL] Reference number please for this call?
[AGENT][NEUTRAL] Um, so the reference number would be my first name, um, last initial, so first name [PII], last initial [PII] as in [PII], and then today's date.
[CUSTOMER][POSITIVE] Perfect thank you so much I appreciate it.
[AGENT][POSITIVE] OK, thanks for calling APL have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.