AccountId: 011433970860
ContactId: 87897f59-da8a-4e22-a863-8ea9ea21afb0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216919 ms
Total Talk Time (AGENT): 67864 ms
Total Talk Time (CUSTOMER): 77070 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/87897f59-da8a-4e22-a863-8ea9ea21afb0_20250429T18:58_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hold on, yes, hi [PII]. My name is [PII]. I'm calling from Doctor [PII]'s office. I need to go over benefits for our patients gap plan.
[AGENT][NEUTRAL] What's your callback number [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, what is the policy number?
[CUSTOMER][NEUTRAL] It is 1659502.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, and you're calling for outpatient benefits for the member, is that correct?
[CUSTOMER][NEUTRAL] Yes, I, I need to know because she has a deductible with her primary plan if this gap plan is gonna cover procedures or in the doctor's office.
[AGENT][NEUTRAL] OK, so outpatient benefits, one moment please.
[AGENT][NEUTRAL] OK, please note verification of benefits provided does not guarantee payment. We pay up to $7900 for the calendar year, uh, that will help with services inside the doctor's office.
[CUSTOMER][NEUTRAL] OK, so you will pay for procedures rendered in the doctor's office but not the office visit.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK great so may I have a reference number for the call thank you.
[AGENT][NEUTRAL] Um, actually, give me one moment. Can I place you on hold, [PII]? one moment. Thank you.
[CUSTOMER][NEUTRAL] Yes, that's fine, thanks. You are on hold.
[AGENT][NEUTRAL] Hm, OK.
[AGENT][NEUTRAL] OK, thank you so much for your patience, [PII]. I let me just retract that we will pay for an office visit. Would this be for a specialist or PCP?
[CUSTOMER][NEUTRAL] Then you can.
[CUSTOMER][NEUTRAL] It's for a specialist, uh, APL doesn't pay for office visits, I don't think.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This plan does, and for a specialist office visit we pay up to $50 per visit with a max of 4 visits per year per person.
[CUSTOMER][NEUTRAL] So you pay also you pay up to $50 so she has a $60 co-pay so that she would have to pay us $10. So has she, has used up any visits? Is it the same it's the 3 remaining visits.
[AGENT][NEUTRAL] OK, let me check that for you.
[AGENT][NEUTRAL] Let me check that for you for this year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, the member has used
[AGENT][NEUTRAL] No visits this year. No visits have been used for this year.
[CUSTOMER][NEUTRAL] Give me a second. OK, 50 $50. He has how many visits remaining?
[AGENT][NEUTRAL] Currently all 4 we pay up to $50 per visit.
[CUSTOMER][NEUTRAL] Hold on please. OK, all visits are remaining. OK, so you only pay up to $450 for 4 visits and they're all remaining right now. I got it. OK, great. So let me have a reference number for the call.
[AGENT][NEUTRAL] It'll be my name, and last initial [PII] in today's date. Anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] OK, [PII], that's all. Thank you. All right, bye bye. Thanks.
[AGENT][POSITIVE] Thank you. Bye.