AccountId: 011433970860
ContactId: 9d4f4bc1-0c43-46f4-8d80-96f96a129c26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298929 ms
Total Talk Time (AGENT): 89073 ms
Total Talk Time (CUSTOMER): 95253 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/9d4f4bc1-0c43-46f4-8d80-96f96a129c26_20250304T18:53_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling API. My name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hey [PII], it's Morgan Webb and Broker Resources. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm well. I have [PII] on the phone. He's a [PII] broker with us, and he has a question about a sleep study being covered. He hasn't given me, oh, he hasn't given me like a specific, um, insured or group. Would you mind speaking with him?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, I hope he has a group number. I won't be able to pull up a policy. OK.
[CUSTOMER][NEUTRAL] Yeah, um,
[CUSTOMER][POSITIVE] Yeah, he's a, he's a funny one, but I will join you guys. Thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hey [PII], I have claims on the line for you.
[CUSTOMER][POSITIVE] Thank you. Of course, have a good day.
[CUSTOMER][NEUTRAL] Right. Hello.
[AGENT][NEUTRAL] Hi, this is [PII] with APO claims department. Um, do you have a policy number?
[CUSTOMER][NEUTRAL] Hey [PII].
[CUSTOMER][NEUTRAL] Um, I do, but what's the difference? I'm just really wanna know if you cover a sleep study or not.
[AGENT][NEUTRAL] Well, that would depend on the policy. I don't know if you're calling with for a meddling policy or HR policy or, I mean, uh.
[CUSTOMER][NEUTRAL] Oh, that's a good question. Well, the group is called Sunshine Spice.
[CUSTOMER][NEUTRAL] Sunshine Spice, you might have him as [PII]
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, and I can only search by group number.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Let's see, I don't know if you sent me. I'm waiting on you to send me the, the, the renewals for May. Oh, here it is. I found it 232-5023250.
[AGENT][NEUTRAL] 232-50. OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Looks like I'll just choose a random person.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] This is gonna be determined on how they're billing for the sleep study.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if they bill place of service 22, it'll go under the outpatient. If they bill place service 11, it'll go under the um.
[AGENT][NEUTRAL] The office treatment writer, but any of those at home place of services is gonna be denied.
[CUSTOMER][NEUTRAL] OK, so let me make a couple of notes here.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] At home
[AGENT][NEGATIVE] It's not gonna be covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and then what was the other one?
[AGENT][NEUTRAL] Outpatient facility is gonna be covered under the outpatient benefit and then if they, if they bill it as um.
[AGENT][NEUTRAL] Office, it'll go on the office treatment writer.
[CUSTOMER][NEUTRAL] They have an office treatment rider.
[AGENT][NEUTRAL] I don't know. I, I'm looking at a just a random person's policy and the one that I have pulled up just randomly has it, so I can't, you know, like without a specific person I can't.
[CUSTOMER][NEUTRAL] Yeah, I mean, well, if they have, they only have, they only have one gap plan. So if it's it um if it's uh this lady's name, uh her name is [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm showing she has the rider.
[CUSTOMER][NEUTRAL] He does. OK, well they could build it one of three ways at home as an outpatient or in a doctor's office, OK.
[CUSTOMER][POSITIVE] Thank you appreciate your help.
[AGENT][POSITIVE] Thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.