AccountId: 011433970860
ContactId: 8b7eafe7-31fe-4e23-8a0a-a7db55abffae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202279 ms
Total Talk Time (AGENT): 90213 ms
Total Talk Time (CUSTOMER): 62240 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/8b7eafe7-31fe-4e23-8a0a-a7db55abffae_20250509T14:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ETL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I'm calling from the doctor's office, and I'm having questions regarding benefits. Can you please assist me on that?
[AGENT][NEUTRAL] Mhm I can help you and you said your name is [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK. What's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Oh, yes.
[CUSTOMER][NEUTRAL] 02496150.
[AGENT][NEUTRAL] Can I get a phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Oh, yes.
[CUSTOMER][NEUTRAL] Patient is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thanks for verifying that, [PII]. So I'm showing an effective date of [PII]. The policy is active at this time and we're checking for office visit benefit.
[CUSTOMER][NEUTRAL] Uh, uh, regarding mental health benefits.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] For outpatient office, yeah.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so actually, uh, I need to know whether it will be covering the primary deductible copay or co-insurance.
[AGENT][NEUTRAL] OK. And you said mental health. What's the cheap complaint?
[CUSTOMER][NEUTRAL] Uh, that is, uh, just for the consultation.
[AGENT][NEUTRAL] I know it, but what for what? I mean, what's the major complaint? Why are they visiting you today?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, actually, I don't have, uh, that kind of information.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Alright, so the for service in a specialist or a PCP office, the physician office visit fee or the copay is not covered, but covered treatment can be considered under the outpatient benefit. So did you want that benefit?
[CUSTOMER][NEUTRAL] Oh yes.
[AGENT][NEUTRAL] OK, so for covered treatment in the office, uh, under this policy, the inpatient and outpatient benefit is combined for a maximum of up to $2500. That's per covered person per calendar year.
[AGENT][NEUTRAL] And of course any information provided is verification it's not a guarantee of payment and let me, I don't show any of that benefit used this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, so still the 2500 is reminding.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much, ma'am. And uh can I have the reference number?
[AGENT][NEUTRAL] Uh, you'll use my name and today's date as reference. It's [PII].
[AGENT][NEUTRAL] [PII] and then first initial last name.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] OK, thank you so much, uh, [PII], for the information and have a wonderful day. Bye-bye.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you.