AccountId: 011433970860
ContactId: 6cb8007e-ff9e-42dd-b06f-7d990117a431
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230949 ms
Total Talk Time (AGENT): 91751 ms
Total Talk Time (CUSTOMER): 89413 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/6cb8007e-ff9e-42dd-b06f-7d990117a431_20250306T14:24_UTC.wav
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[AGENT][NEUTRAL] APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII] is my last name initial. I'm going to check the benefits of a policy.
[AGENT][NEUTRAL] OK this for service in a doctor's office.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and spell your first name for me?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] [PII], OK, and what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] The policy number is 01659488 M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] The phone number is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] You know.
[CUSTOMER][NEUTRAL] He is [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So I'm showing the policy effective date of [PII]. This policy is active at this time.
[AGENT][NEUTRAL] And office visit.
[AGENT][NEUTRAL] Under this policy, the.
[AGENT][NEUTRAL] Physician visit is not covered?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] But I do show that there is a treatment writer under this plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry, I believe there is a physician's visit. Give me one second, let me pull the policy, OK?
[CUSTOMER][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello, sorry, your name is um you said.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is from
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And is this a PCP office or a specialist?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] For a specialist office.
[AGENT][NEUTRAL] OK, so there is a specialist office visit fee under the policy, which covers up to $50 per visit.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] A maximum of 4 visits per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] And I show that this is an individual policy, and I'll check to verify if any has been used.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, 23.
[AGENT][NEUTRAL] So currently I don't show you any of the visits used at this time and of course any information provided is verification, not a guarantee of payment, uh, [PII], and did you have any other questions we can help out with today?
[CUSTOMER][NEUTRAL] Um, I would like to check the benefits for the, um, diagnosis testing.
[AGENT][NEUTRAL] In the office?
[CUSTOMER][NEUTRAL] Yes, in a specialist office.
[AGENT][NEUTRAL] OK, so the maximum outpatient benefit.
[AGENT][NEUTRAL] It's up to $7900 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And none of that has been used at this time.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much for the information. Um, can I have your name one more time? Sorry?
[AGENT][NEUTRAL] Uh, you'll use my name in today's state as your reference, [PII] First initial last name is [PII], and anything else, [PII]?
[CUSTOMER][POSITIVE] No, that will be everything. Thank you so much for your help today.
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yes sir bye bye.
[AGENT][NEUTRAL] Bye bye.