AccountId: 011433970860
ContactId: c10db2ac-9166-434f-a36f-4d0ff594de2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284739 ms
Total Talk Time (AGENT): 117144 ms
Total Talk Time (CUSTOMER): 56399 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/c10db2ac-9166-434f-a36f-4d0ff594de2c_20250409T20:43_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. Initial of my last name is [PII]. I am calling from cardiologist Doctor [PII]'s office. We have a patient and he would like to know if his secondary covers office visits, co-pays.
[AGENT][NEUTRAL] OK, sure. I can assist you with that information, Miss May. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, 02550775.
[AGENT][NEUTRAL] Um, OK, let me have that number one more time. I think I got too many numbers.
[CUSTOMER][NEUTRAL] It's 02550775.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, [PII], [PII].
[AGENT][NEUTRAL] All right. Thank you. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our secondary supplemental plan to the major medical. And let me check and see if we cover office visits. One moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so based on the benefit of the policy, it looks like we are covered, let's see.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me check this other benefit. It's not clear to me. Give me just a second. Let me pull the certificate and see if it's more clear there. 01 moment.
[AGENT][NEUTRAL] Yeah, this is one of our newest products, so some of them does have that office visit benefit, but some of them don't.
[CUSTOMER][NEGATIVE] I'm sorry, you're breaking, breaking in and out. I couldn't hear you.
[AGENT][NEUTRAL] OK, I'm so sorry for that. Um, give me just a second. Um, this is one of our newest products, so, um, there's some that do have that office visit benefit, but there's some that don't, so I'm just trying to find out if this one does.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. Now, this one doesn't cover the office visit, it only covers office procedures and that's subject to the outpatient maximum.
[AGENT][NEUTRAL] Of 3000.
[CUSTOMER][NEUTRAL] OK, give me 1 2nd.
[CUSTOMER][NEUTRAL] And you say covers procedures?
[AGENT][NEUTRAL] Procedures, yes. So any procedures or treatment done in the office is what we cover.
[CUSTOMER][NEUTRAL] And the maximum is up to $3000.
[AGENT][NEUTRAL] Yes, and this is a combined benefit with inpatient and outpatient service.
[CUSTOMER][NEUTRAL] OK, ma'am. Is there a reference number to this call?
[AGENT][NEUTRAL] We don't have reference numbers, so you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK. Can I have your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] OK, ma'am. Thank you very much. You have a great day.
[AGENT][POSITIVE] You as well, and thank you for calling APL. mhm Bye-bye, Miss [PII].