AccountId: 011433970860
ContactId: b385625d-a92b-4572-9cf0-ed9693cbc103
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260309 ms
Total Talk Time (AGENT): 98816 ms
Total Talk Time (CUSTOMER): 102558 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/b385625d-a92b-4572-9cf0-ed9693cbc103_20250331T19:27_UTC.wav
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[CUSTOMER][NEGATIVE] You're sick. Is that why you were coming today because you were sick last week.
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from Doctor [PII] Perez office primary care. I'm calling to check benefits on a patient.
[AGENT][POSITIVE] OK, I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, policy number is 1719382.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And also
[AGENT][NEUTRAL] And what's that patient name and date of birth?
[CUSTOMER][NEUTRAL] So it's
[CUSTOMER][NEUTRAL] Um, his name is [PII].
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And did you say benefits, is that correct?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Looks like this policy number's termed, but let me see if he has a current one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm
[AGENT][NEUTRAL] OK, he does have an active policy, um, under a different number. Can I give you that number?
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] Uh, that policy number is 2555889.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and is this through APL?
[AGENT][POSITIVE] Yes it is and this is uh effective [PII] and it's active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and where do we submit the claims to?
[AGENT][NEUTRAL] Uh, the claims can be mailed mailed or faxed, or, uh, we have a payer ID. Which one would you like?
[CUSTOMER][NEUTRAL] Uh, payer ID?
[AGENT][NEUTRAL] Our payer ID is 60801.
[CUSTOMER][NEUTRAL] 01 OK let me get the the address just in case.
[AGENT][NEUTRAL] Sure. It's uh [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's [PII].
[CUSTOMER][NEUTRAL] OK, so that's um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and it's APL OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, is it, uh, does it cover, uh, co-pays for primary care?
[AGENT][NEUTRAL] Um, let's see what's covered under here, so.
[AGENT][NEUTRAL] This is not a guarantee of payment. It's just a basic outline of the policy. Um, it will not cover the office visit itself, but it will cover up to 6000 per calendar year for treatment and procedures performed in the office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so any labs, diagnostics, hospitals?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK, so not the office visits, so treatment.
[AGENT][NEUTRAL] Not the office itself.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And your name?
[AGENT][NEUTRAL] My name is [PII] and last initial is [PII].
[CUSTOMER][NEUTRAL] OK, can I have a reference number please?
[AGENT][NEUTRAL] Uh, just be my first name, last initial, and today's date.
[CUSTOMER][NEUTRAL] OK, and it's [PII]?
[AGENT][NEUTRAL] Uh, it's [PII]
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII]. Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.