AccountId: 011433970860
ContactId: 779d083e-6457-48a8-8ac0-d72a14266d0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 135000 ms
Total Talk Time (AGENT): 61042 ms
Total Talk Time (CUSTOMER): 59098 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/779d083e-6457-48a8-8ac0-d72a14266d0f_20250306T19:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII].
[CUSTOMER][NEUTRAL] Hi, hello, good afternoon. My name is [PII]. I'm calling from a provider's office in regards to mutual patients benefits.
[AGENT][NEUTRAL] OK, you said your name is [PII]?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK. And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] I have 02585907 M L for Larry 8.
[AGENT][NEUTRAL] And your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] It is for a specialist.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Take care. OK, thank you, bye.
[CUSTOMER][NEUTRAL] Here
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thanks for that information, [PII]. I'm showing an effective date of [PII] currently active at this time.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And under her policy, the physician visit fee is not covered. Um, there is a treatment rider, so there's covered treatment, those items can be considered under the outpatient benefit.
[CUSTOMER][NEUTRAL] right.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so she doesn't have any coverage as a professional fee.
[AGENT][NEGATIVE] For the copay, she does not, for the physician's fee, she does not.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so what is it that you guys cover?
[AGENT][NEUTRAL] If, if there's treatment in the office, covered treatment can be considered.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Under the outpatient benefit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so does she have an annual maximum or no?
[AGENT][NEUTRAL] OK, so it just depends on what type of service it is, [PII]. So will there be any treatment in the office, X-rays, diagnostic testing, injections, anything like that? or is it just for the the office visit fee?
[CUSTOMER][NEUTRAL] OK, so we can just send out the billing to the primary and the secondary, and you guys cover whatever it is that you guys wanna cover.
[AGENT][NEUTRAL] OK, any other questions?
[CUSTOMER][POSITIVE] That'll be it thank you so much for your help have a good day.
[AGENT][POSITIVE] Uh, you're welcome. Thanks for calling APL. Have a good day.