AccountId: 011433970860
ContactId: 76ce2d98-1311-480f-9e9e-f89b79d58dba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213520 ms
Total Talk Time (AGENT): 78614 ms
Total Talk Time (CUSTOMER): 72969 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/76ce2d98-1311-480f-9e9e-f89b79d58dba_20250508T18:46_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII], I'm calling from Doctor [PII]'s office. I need to go over benefits for our patients gap plan.
[AGENT][NEUTRAL] OK, I can verify benefits for you and your name is?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] 02465840 ML 8
[AGENT][NEUTRAL] Thank you. One moment. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] OK, I sure she had a policy with us effective [PII] and it terminated [PII].
[AGENT][POSITIVE] Oh, she does have active, yes, but I do show she has active coverage and I'll give you that policy number when you're ready.
[CUSTOMER][NEUTRAL] So it's a termination.
[CUSTOMER][NEUTRAL] Alright, what's that policy number?
[AGENT][NEUTRAL] It's 1659812.
[CUSTOMER][NEUTRAL] OK, 1659812. All right, and so does she um have benefits for procedures under in the doctor's office?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, she does have a router, yes, uh, she has a router covers office visits and procedures in the office.
[CUSTOMER][NEUTRAL] OK, so procedures in the office are covered.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And you said that the office visit is covered as well because she has a copay of $60 for the office visit.
[AGENT][NEUTRAL] Yeah, she has a router that covers office visits. Usually they don't, but this her policy does.
[CUSTOMER][NEUTRAL] Usually these plants don't cover.
[CUSTOMER][NEUTRAL] And it does to up to how much?
[AGENT][NEUTRAL] Uh, let's see, not a guarantee of payment, just a verification coverage up to 25 for a general 54 specialists.
[CUSTOMER][NEUTRAL] OK, so then it covers up to $50 because her copay is $60. It covers up to $50. Does it give you so many visits when it covers like 4 visits per year?
[AGENT][NEUTRAL] Uh, she has a total of 4 visits per calendar year.
[CUSTOMER][NEUTRAL] OK, has she used up all the visits or she still has some available?
[AGENT][NEUTRAL] Um, one moment.
[AGENT][NEUTRAL] Uh let's see.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I don't sure if she's used any visits for this year.
[CUSTOMER][NEUTRAL] OK, so she's OK, let me have your payer ID.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright then, so um 1659812. Alright, let me have a reference number for this call, please. Thank you.
[AGENT][NEUTRAL] You may use my name in today's date if you like.
[CUSTOMER][NEUTRAL] Your name is [PII]?
[AGENT][NEUTRAL] Correct, and last initial [PII]
[CUSTOMER][POSITIVE] Alright thank you alright bye bye thank you bye.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, ma'am. Thank you for calling APL bye.
[CUSTOMER][POSITIVE] You're welcome bye.