AccountId: 011433970860
ContactId: a5fc5924-ff50-402a-8435-5b61a5d7ca48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 144919 ms
Total Talk Time (AGENT): 46747 ms
Total Talk Time (CUSTOMER): 73156 ms
Interruptions: 1
Overall Sentiment: AGENT=2.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/a5fc5924-ff50-402a-8435-5b61a5d7ca48_20250317T13:31_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, good morning. My name is Doctor [PII].
[AGENT][POSITIVE] Yes, sir. How can I help you?
[CUSTOMER][NEUTRAL] I'm calling for a patient named [PII].
[CUSTOMER][NEUTRAL] And her policy number is 02584452.
[AGENT][NEUTRAL] Thank you, doctor. And, and uh if I could just have her date of birth and a phone number, please?
[CUSTOMER][NEUTRAL] OK, let me go to her chart.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, so her date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] I do appreciate that, sir. If I could just have a callback number, I'd appreciate it.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for contacting us, doctor. How may I help you?
[CUSTOMER][NEUTRAL] So we have billed her for office duties. The charge was.
[CUSTOMER][NEUTRAL] Honey, uh, but let me see was for [PII].
[CUSTOMER][NEUTRAL] And let me go to charge, the charge was $200.
[CUSTOMER][NEUTRAL] And I got explanation that not covered procedure. The procedure was CPD code 99213, which is level 3 office visits.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So we would like to know why it is not covered.
[AGENT][NEUTRAL] Certainly, um
[CUSTOMER][NEUTRAL] Anything wrong?
[AGENT][NEUTRAL] Oh, no, no, no, no, no. So this is uh a limited benefit hospital indemnity policy and what it covers is, is very, very specific. So this is not major medical. Um what it covers, sir, is, is uh some very, very specific things such as um in hospital visits if she were admitted to the hospital, um, that would be one of the covered benefits.
[CUSTOMER][NEUTRAL] Oh, this our insurance would not cover doctor's visit.
[AGENT][POSITIVE] That's correct. That's right, sir, because it, it only, it's only gonna cover, OK.
[CUSTOMER][NEUTRAL] OK, I will let her know. OK, so I will let her know that insurance is not good for the office, you know, and then she has to pay out of her pocket. OK, no problem, thank you, no problem, mhm, bye bye, yeah.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Oh, OK. If there's nothing else I can help with. Thanks for contacting.