AccountId: 011433970860
ContactId: 91430ed3-9d54-4427-b77e-a65fcaecc779
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 132139 ms
Total Talk Time (AGENT): 80252 ms
Total Talk Time (CUSTOMER): 42778 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/91430ed3-9d54-4427-b77e-a65fcaecc779_20250109T22:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. I'm calling from Doctor [PII]'s office. Any benefits on a patient's gap plan?
[AGENT][NEUTRAL] OK, I can look at those benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number is 01611766ML8.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that information, [PII]. Uh, so this policy is active. Effective date was [PII], so this is a secondary medical policy. It is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] And we we needing to look at outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, he has a deductible with his primary plan. So any procedures rendered in the doctor's office would be the patient's responsibility. So this this gap plan cover the procedures rendered in the office, and is this his correct ID number because I see a lot of APL policy numbers are changing.
[AGENT][NEUTRAL] Yeah, this is the active policy number. This is correct. OK, and I'm so sorry, [PII], but we're needing to see if uh treatment received in office is covered, is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So yes, he does have the benefit for treatment receipts in office. Uh, the outpatient benefit is $1500 max per calendar year. I know the year just started, but I will double check to see if any of that has been used. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, no, none of that has been used so far this year.
[CUSTOMER][POSITIVE] OK great
[CUSTOMER][NEUTRAL] So let me have a reference number for the call thanks.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date, and so my name is spelled [PII]
[AGENT][NEUTRAL] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] All right, great.
[CUSTOMER][POSITIVE] No, that will be all thank you bye bye thanks.
[AGENT][POSITIVE] Alright, thanks for calling APL. Have a great day. Thank you.
[CUSTOMER][POSITIVE] You're welcome. You too.