AccountId: 011433970860
ContactId: 6aa5ed83-32a2-4f53-85a8-e0ba8a06f23c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158360 ms
Total Talk Time (AGENT): 38729 ms
Total Talk Time (CUSTOMER): 82190 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/6aa5ed83-32a2-4f53-85a8-e0ba8a06f23c_20250625T18:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. I'm calling for Doctor [PII]'s office, and I need to go over benefits on the patient, please.
[AGENT][NEUTRAL] OK. Can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] My name is [PII]. Callback number is [PII].
[AGENT][NEUTRAL] OK, [PII], I can help you with benefits. Do you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Yes, it is 02064017.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK so the policy is active and effective [PII] and you need outpatient benefits.
[CUSTOMER][NEUTRAL] Yes, I need to know if the patient has benefits for procedures registered in the office.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Such as a biopsy. The last time I did call this plan, the patient only had benefits for $25 towards his office visit. I don't know if his plan has updated since that time.
[AGENT][NEUTRAL] OK. Uh, let me pull it up. One moment.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] So since he has a deductible with his primary plan, any procedures rendered in the doctor's office would be the patient's responsibility.
[AGENT][NEUTRAL] Uh, it's not a guarantee of payment basic outline of the policy. Yes, I just showed the $25 per visit, a max of 4 visits per calendar year. That's for the.
[CUSTOMER][NEUTRAL] Ha
[CUSTOMER][NEUTRAL] Right towards the office visit copay correct?
[AGENT][NEUTRAL] Uh, it's physician outpatient treatment.
[CUSTOMER][NEUTRAL] Right, does it go towards the, the co-pay or does it go towards a procedure because I was told it went towards the copay, so it helps him pay the copay.
[CUSTOMER][NEUTRAL] OK, see, I called back on this plan last year and I was told the gap plan covers up to $25 a day for the office visit with only 4 visits per year.
[CUSTOMER][NEUTRAL] The patient does not have coverage for procedures in the office.
[AGENT][POSITIVE] Uh, yes, that's correct.
[CUSTOMER][NEUTRAL] So if that's the case, that's how it is. It's not they're not gonna pay $25 towards the procedure.
[AGENT][NEUTRAL] Yes, $2025 per visit, a max of 4 visits.
[CUSTOMER][NEUTRAL] Right, the $25 for the visit, it helps to pay the copay. May I have a reference number for the call?
[CUSTOMER][NEUTRAL] Hold on please. I need a reference number, yeah.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] [PII], today's date. Thanks.
[CUSTOMER][POSITIVE] OK, [PII] in today's date thank you bye bye.