AccountId: 011433970860
ContactId: 66a92325-db60-45f0-95bc-5179c7f76735
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250339 ms
Total Talk Time (AGENT): 108246 ms
Total Talk Time (CUSTOMER): 131440 ms
Interruptions: 7
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/66a92325-db60-45f0-95bc-5179c7f76735_20250108T18:21_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 am calling from Doctor [PII]'s office. I need to go with benefits for our patients.
[AGENT][POSITIVE] OK, I can help you with benefits for the patient. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] It's [PII] and that's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what's [PII]'s policy number?
[CUSTOMER][NEUTRAL] Um, I have two different numbers. I have here 1 021502-11 ML8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's fine that one number will pull in the policy number for me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Has that policy number changed to 02462631? OK.
[AGENT][NEUTRAL] Yes, I was just getting ready to tell you that policy number, the 2150211 ML8 that policy did expire or terminate.
[CUSTOMER][POSITIVE] Yeah, what, what I like.
[CUSTOMER][NEUTRAL] Uh, OK, OK.
[AGENT][NEUTRAL] Um, on [PII].
[CUSTOMER][NEUTRAL] Fax it. OK. Yeah, can you tell me if procedures are covered in this in for with this gap plan? 356-91.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] OK, let me look and see for you and this is just to verify coverage. It's not a guarantee of benefits. This is a supplemental policy.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 3056691362.
[AGENT][NEUTRAL] That helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] OK, so our procedures rendered in the office covered?
[AGENT][NEUTRAL] I'm checking now for you to see if there's office visits available.
[CUSTOMER][POSITIVE] I I want one of them, another morning first.
[CUSTOMER][NEUTRAL] Well, I'm looking for office procedures. This plan usually doesn't cover office visits.
[AGENT][NEUTRAL] Right, so the reason what I'm trying to tell you is this, this policy only covers for deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] that
[AGENT][NEUTRAL] It has
[CUSTOMER][NEUTRAL] Right, so our procedures rendered in the office covered with this plan?
[AGENT][NEUTRAL] Let me check for you.
[CUSTOMER][NEUTRAL] It's supposed to see
[CUSTOMER][NEUTRAL] Yes, they do cover procedures in the office or no they yeah no they.
[AGENT][NEUTRAL] Of
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It has an office treatment writer.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And he does have um outpatient, uh, let's see, outpatient benefits of.
[AGENT][NEUTRAL] Let me give you the benefit amount per calendar year.
[CUSTOMER][NEUTRAL] It was
[CUSTOMER][NEUTRAL] need to
[AGENT][NEUTRAL] It's $350 per calendar day.
[CUSTOMER][NEUTRAL] And legally.
[CUSTOMER][NEUTRAL] Yes, coverage they do cover office visits with this plan because on here, um, in December he was here in December and they did cover the visit. They only, they only cover, they only paid $55.
[AGENT][NEUTRAL] OK. So that would be for the deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Right, his co-pay is 55%, so they only cover that. They don't cover the procedure.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so may I have a reference number for the call. So they cover up to $350 for just for the, the they actually for the co-pay, they don't cover the procedure because the patient's, um, insurance covers the proc actually his his primary plan covers the procedures.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, so may I have a reference number for the call?
[AGENT][NEUTRAL] Yes ma'am, you can use my name it's [PII] and today's date.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] [PII] OK, thank you.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. You have a great day and thanks for calling APL.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Uh, likewise bye bye thanks bye.
[AGENT][NEUTRAL] All right. Bye-bye.