AccountId: 011433970860
ContactId: 9bc28336-59b6-4c3a-aaa6-a8a7bdf73b47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 141050 ms
Total Talk Time (AGENT): 65886 ms
Total Talk Time (CUSTOMER): 59661 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/9bc28336-59b6-4c3a-aaa6-a8a7bdf73b47_20250114T14:27_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, good morning, my name is [PII]. I'm calling from Urology specialty care and I just wanted to get benefits for a patient's insurance.
[AGENT][NEUTRAL] OK, and so this is in a physician's office?
[CUSTOMER][NEUTRAL] This is a physician's office.
[AGENT][NEUTRAL] OK, what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Policy number is 02216481ML8.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for that information. And so I'm showing an effective date of [PII], the policy is active at this time, and you said for office visit under this under this policy, the physician's visit fee is not covered. Do you know what the chief complaint is?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The specialist is
[CUSTOMER][POSITIVE] Uh, give me one second and I can get that for you.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Cause there's an office treatment writer under this policy, but it's as a result of a cancer diagnosis.
[CUSTOMER][NEUTRAL] No it's not cancer.
[AGENT][NEUTRAL] OK, yeah, so it's the, the physician's visit fee is not covered under this uh policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, do you still need the diagnosis or no?
[AGENT][NEUTRAL] Uh, no, because I was just trying to verify if it was a, uh, yeah.
[CUSTOMER][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] Are in office procedures covered done in a specialist office?
[AGENT][NEUTRAL] If it's a diagnosis of cancer.
[CUSTOMER][NEUTRAL] So unless it's a diagnosis of cancer nothing's covered?
[AGENT][NEUTRAL] Under this policy in the office? No.
[CUSTOMER][POSITIVE] OK, perfect. Can I get your uh name one more time and a reference number?
[AGENT][NEUTRAL] Mhm. You'll use my name and today's state as your reference. [PII], first initial of my last name is [PII] [PII]. Any other questions?
[CUSTOMER][POSITIVE] No that was all thank you so much for your help hope you have a great day.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Mm you too.