AccountId: 011433970860
ContactId: 96b61865-9b5a-4303-8362-df674e90b449
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195500 ms
Total Talk Time (AGENT): 69989 ms
Total Talk Time (CUSTOMER): 58084 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/96b61865-9b5a-4303-8362-df674e90b449_20250512T19:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, this is [PII] from Orthopedic Surgeons of Georgia. I am needing to see um what a patient's co-pay should be for a special visit.
[AGENT][NEUTRAL] OK, I can help you with that, [PII]. Do you have the uh good callback number?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of that patient?
[CUSTOMER][NEUTRAL] 01735273
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh, looks like that policy terminated in 24. Let me see if he's got a current one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah, it looks like he's got a current policy. Let me get that pulled up.
[AGENT][NEUTRAL] OK, let me give you that current policy number. It's 2500293.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, this policy is effective [PII]. It's active.
[AGENT][NEUTRAL] And you said outpatient uh surgery, is that right?
[CUSTOMER][NEUTRAL] Um, no, ma'am, specialist, uh, office visit.
[AGENT][NEUTRAL] Offices, I'm sorry. OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] It's not a guarantee of payment, basic outline of the policy.
[AGENT][NEUTRAL] Get that pulled up, one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEGATIVE] Uh, this plan doesn't have any coverage for an office visit.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] This is like a secondary um gap plan, so.
[CUSTOMER][NEUTRAL] Yes ma'am, I was just looking at the note the insurance specialist put that they spoke with a rep.
[CUSTOMER][NEUTRAL] On [PII] and says insurance pays.
[CUSTOMER][NEUTRAL] $2500 of his office visits as secondary.
[AGENT][NEUTRAL] Um, well, it doesn't actually pay for the actual office visit? It does pay for outpatient services.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, so like ER surgery, uh, diagnostic testing in the hospital, um, things like that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you so much and can I just get a call reference number please?
[AGENT][NEUTRAL] Uh, call reference numbers, my name is [PII], first initial to last name [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.