AccountId: 011433970860
ContactId: 60c6f9f8-ad3f-42aa-9afa-70541ff6a281
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226839 ms
Total Talk Time (AGENT): 112686 ms
Total Talk Time (CUSTOMER): 70458 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/60c6f9f8-ad3f-42aa-9afa-70541ff6a281_20250421T20:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I have a mutual patient that has a gap insurance and I need to know what applies to the office is it.
[AGENT][POSITIVE] OK, I can help you with um the benefits for a patient. May I please get your call back number just in case your call our call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then what is your name and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] [PII] Florida Foot and Ale Associates.
[AGENT][NEUTRAL] OK, thank you. And Miss [PII], what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII], uh, policy number is 02562814.
[AGENT][NEUTRAL] OK. And Ms. [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you ma'am. I appreciate that. Let me pull up her policy for us real quick.
[AGENT][NEUTRAL] Alright, I do show that [PII]'s policy is active. Uh, she does have an effective date of [PII].
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. She does have.
[AGENT][NEUTRAL] Outpatient benefits.
[AGENT][NEUTRAL] Uh, let me check that real quick to see.
[CUSTOMER][NEUTRAL] Mhm. How much is out of pocket, yeah.
[AGENT][NEUTRAL] Right. She has uh uh
[AGENT][NEUTRAL] $5000.
[AGENT][NEUTRAL] Uh, per calendar year for outpatient deductible, co-pay or co-insurance, but I need to check to see if office visits are covered under her plan, so it's gonna be just a second while I pull up her policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I yeah and also the doctor didn't, yeah, and her, the doctor did an injection to see if that's under that as well.
[AGENT][NEUTRAL] OK, let me check.
[AGENT][NEUTRAL] It's gonna be just one moment.
[CUSTOMER][POSITIVE] No problem. What was your name? I'm sorry?
[AGENT][NEUTRAL] My name is [PII], it's [PII]
[CUSTOMER][POSITIVE] OK, thank you Miss [PII].
[AGENT][NEUTRAL] OK, so on her policy, uh, the treatment in a physician's office is covered, but the physician's office visit fee is not covered.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] No, no copay, but the injection covered.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] The, the treatment in a physician's office is covered.
[CUSTOMER][NEUTRAL] Yes, that was a treatment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then the physician's office visit fee is not covered.
[CUSTOMER][NEGATIVE] Is not covered so the injection that was what he did to treat her is covered, but the copay is not correct.
[AGENT][NEUTRAL] Yes, the treatment itself.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Alright perfect if I can have a reference number that we spoke.
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I hope you have a wonderful rest of your week and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Mm bye-bye.