AccountId: 011433970860
ContactId: 923a2f00-c02a-4259-a27f-2b604479cc99
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161550 ms
Total Talk Time (AGENT): 72121 ms
Total Talk Time (CUSTOMER): 56360 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/923a2f00-c02a-4259-a27f-2b604479cc99_20250506T17:35_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'm calling you from Doctor [PII]'s office in regards to eligibility and benefits for a patient.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. And [PII], may I have a good contact number in case we disconnected and the policy number?
[CUSTOMER][NEUTRAL] 305
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the policy number is 02518760.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] OK, um, what does this gap cover all co-payments for specialists?
[AGENT][NEUTRAL] So we pay towards the copay, deductible and co-insurance of covered charges after primary, um, for the office setting, the policy will pay up to $300 per calendar day, um, and that does include physician office, specialist office, um, it's just treatment in the physician's office.
[CUSTOMER][NEUTRAL] OK, and there's no difference in seeing uh the provider and studies, right? Because we do studies here as well, it would cover it too.
[AGENT][NEUTRAL] Um, so, yes, any, well, for the most part, any treatment as long as it's not cosmetic, um, there is also
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] When you say study, I don't know, there's also a sleep study benefit here, um, and infusion therapy, so there's a few different.
[CUSTOMER][NEUTRAL] Well, we do just, uh huh.
[CUSTOMER][NEUTRAL] Mostly we do stress stuff and echocardiograms.
[AGENT][NEUTRAL] OK, um, as long as this treatment in the office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so, um, you said that she has $300 for what?
[AGENT][NEUTRAL] Day.
[CUSTOMER][NEUTRAL] Per day, OK.
[CUSTOMER][POSITIVE] OK, thank you so much and uh that's all I needed.
[AGENT][POSITIVE] Alrighty, well, thank you so much for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Likewise, take care.
[AGENT][POSITIVE] Thank you. Bye-bye.