AccountId: 011433970860
ContactId: 70d19684-0359-4119-9be7-1316e4d97c9d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155949 ms
Total Talk Time (AGENT): 58447 ms
Total Talk Time (CUSTOMER): 54806 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/70d19684-0359-4119-9be7-1316e4d97c9d_20250422T21:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, hi [PII]. [PII], I would like to check benefits.
[AGENT][NEUTRAL] OK, could I get your name?
[CUSTOMER][NEUTRAL] For one of your members?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] I'm sorry, how do you spell that?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 2003102
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you say benefits, is that correct?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, yes, we're calling from the primary care physician office, so we would like to know if this policy covers copays and deductibles for the primary care.
[AGENT][NEUTRAL] OK, let me uh pull up the policy. It's not a guarantee of payment, basic outline of the policy. Uh, I show this policy is effective [PII] and it's active, and let me get this pulled up. One moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so it does not cover copays, but it will cover treatment or procedures provided in the office up to $7350 per calendar year.
[CUSTOMER][NEUTRAL] What do we call procedures?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Because, uh, the, what do you call the procedures? Because the only thing we do in the primary care physician office is like an office visit and an EKG maybe, you see what I mean?
[AGENT][NEUTRAL] Right, so the office visit itself would not be covered, but any treatment or procedures such as an EKG if you do any type of treatment or procedure besides the actual office visit, it would be covered.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] So the EKG is all you do.
[CUSTOMER][NEUTRAL] OK, and is there
[CUSTOMER][NEUTRAL] Is that, yes, yes, we don't do, we don't do any other procedures. Is there, is there a deductible? No.
[AGENT][NEGATIVE] Uh, no deductible.
[CUSTOMER][POSITIVE] OK. OK, thank you so much. Can I have a reference number for this call, please?
[AGENT][NEUTRAL] Um, it's just my name, [PII], and first initial to last name [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. You have a good night.
[AGENT][POSITIVE] OK, thank you. You too.