AccountId: 011433970860
ContactId: adda4dce-aad3-491d-a381-0f19af8d4dc7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219110 ms
Total Talk Time (AGENT): 101949 ms
Total Talk Time (CUSTOMER): 82417 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/adda4dce-aad3-491d-a381-0f19af8d4dc7_20250212T22:32_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEGATIVE] Hi, um, I was calling to find out how my, so I was trying to set up a doctor's appointment and I, my insurance is not active until the [PII]. Uh, my appointment is for the [PII], but when I tried to give them the information, they said that they don't even accept this insurance. They, they don't have it in their system.
[CUSTOMER][NEUTRAL] So I guess I just wanted to see, is it something that is reimbursed or I don't know, it's a primary care physician.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can check and see what type of product you have with us. Um, may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. My name is [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh my phone number is [PII].
[AGENT][NEUTRAL] OK, and do you have the policy number with you?
[CUSTOMER][NEUTRAL] Yes, it is 02589596.
[AGENT][NEUTRAL] All right, thank you. And let's see, may I have your date of birth, mailing address and email address for verification?
[CUSTOMER][NEUTRAL] [PII] and my address [PII] and you said my email?
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK. And um are you calling about medical or dental?
[CUSTOMER][NEUTRAL] Medical
[AGENT][NEUTRAL] Medical. OK, let me pull this medical. One moment.
[AGENT][NEUTRAL] OK, yes, the medical, if they don't take the card uh where you go in the place of service, uh, you can submit your claim for reimbursement, um, you said it's for an office visit.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Let me check and see how much we cover, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And let's see, bear with me.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so office we cover $75 per visit.
[CUSTOMER][NEUTRAL] OK, so then I would just visit and then um just submit a claim. I would just have some type of receipt or something like that.
[AGENT][NEUTRAL] Um, you need to send the claim form. Uh, the claim form is in our website at [PII], and before you leave the office, just, um, ask for an itemized bill with the diagnosis code.
[CUSTOMER][NEUTRAL] Itemized too.
[AGENT][NEUTRAL] With diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] With diagnosis, what?
[AGENT][NEUTRAL] Diagnosis code.
[CUSTOMER][NEUTRAL] Diagnosis. I don't I feel.
[AGENT][POSITIVE] Yes, it's really important.
[AGENT][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Yes. OK. You're welcome. Is there anything else I can help you with today? Any other questions or concerns?
[CUSTOMER][POSITIVE] All right, thank you so much.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, well thank you for calling APO. Have a good afternoon.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. Bye bye.