AccountId: 011433970860
ContactId: 5f9a11cb-b356-44ae-b097-458adf25b19a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 341880 ms
Total Talk Time (AGENT): 136018 ms
Total Talk Time (CUSTOMER): 93422 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/5f9a11cb-b356-44ae-b097-458adf25b19a_20250407T16:08_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL Tory. How may I help you?
[CUSTOMER][NEUTRAL] Hi good afternoon my name is [PII]. I'm sorry, you said your name was [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from Doctor [PII] at this office. I'm calling because I have a patient that is coming in to do a few testings here in the office, and I just wanted to know if you guys would cover their co-payments.
[AGENT][NEUTRAL] OK, I can help you with benefits, Ms. [PII]. Can I please get your callback number, ma'am, just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. Uh, and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name is.
[CUSTOMER][NEUTRAL] It's, I'm gonna spell it out, it's [PII] Last name is [PII]. Date of birth is [PII]. Policy number is 02458535 ML8.
[AGENT][NEUTRAL] OK, let me look that policy up real quick.
[AGENT][NEUTRAL] OK, and can you spell the doctor's name again for me please?
[CUSTOMER][NEUTRAL] [PII] Last name is [PII]
[AGENT][POSITIVE] Thank you, I appreciate that. All right, so I do show that
[AGENT][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Does have an active policy.
[AGENT][NEUTRAL] The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is just to verify the benefits it's not a guarantee of payment. He has a supplemental policy you're correct, um, that does help with deductible, co-pay and co-insurance. He has an inpatient benefit amount per calendar year of $5000 and then.
[AGENT][NEUTRAL] Patient calendar your benefit amount.
[CUSTOMER][NEUTRAL] I'm sorry, hello? You keep, hello?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] OK, did you hear me? The phone cut out for a minute. It does.
[CUSTOMER][NEUTRAL] No, I couldn't hear you. I'm sorry.
[AGENT][NEUTRAL] OK, so he has the inpatient calendar year benefit amount of $5000 and he has an outpatient calendar year benefit amount also of $5000 to go towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, um, and if it's done in the office, will you guys still cover the.
[CUSTOMER][NEUTRAL] The co-payment?
[AGENT][NEUTRAL] I'm going to check real quick to see if this policy has office visits on it.
[AGENT][NEUTRAL] Let me pull up the policy itself.
[AGENT][NEUTRAL] It's gonna be just a second while the computer pulls it in for us.
[CUSTOMER][NEUTRAL] Sure, no pro
[AGENT][NEUTRAL] OK, let's see what it says about office visits.
[AGENT][NEUTRAL] OK, so the treatment in the office, um, this is just to verify his benefits. It's not a guarantee of payment. Treatment in the office is covered, but the physician's office fee, office visits are not covered by the policy.
[CUSTOMER][NEUTRAL] OK, so the testing will be covered, but not if he's gonna see the doctor.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] You said it's $5000 for the
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is out has he accumulated anything to his out of pocket?
[AGENT][NEUTRAL] Let me check and see.
[AGENT][NEUTRAL] Be just one moment while I pull that in.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] If you have any
[CUSTOMER][NEUTRAL] OK, I think you're just that I already, yeah, I already work and that's all, yeah, no I.
[CUSTOMER][NEUTRAL] Because I, I got rid of the ones that you had left.
[CUSTOMER][NEUTRAL] Yeah, and I canceled those out and then I.
[AGENT][NEGATIVE] Nothing has been used for the year of [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Can I get a reference number?
[CUSTOMER][NEUTRAL] Let me know when you're
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Did you hear nothing has been used for the year of [PII].
[CUSTOMER][NEUTRAL] No,
[CUSTOMER][NEUTRAL] OK, can I get a reference number please?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name. It's [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much have a nice day.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that'll be all have a nice day.
[AGENT][POSITIVE] You have a good day too and thanks for calling APL.