AccountId: 011433970860
ContactId: c6e97122-d726-489e-a785-2ec5daffa49d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147500 ms
Total Talk Time (AGENT): 76816 ms
Total Talk Time (CUSTOMER): 66336 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/c6e97122-d726-489e-a785-2ec5daffa49d_20250312T14:06_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi [PII], I'm calling from Doctor [PII]'s office. I need to go a bit, um, a gap plan for a patient, please.
[AGENT][NEUTRAL] Sure, I can assist you with that. Did you say your name was [PII]?
[CUSTOMER][NEUTRAL] It's [PII]. I'm calling from Doctor [PII]'s office.
[AGENT][POSITIVE] Oh, [PII], can I have a callback number for you and that policy number and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Oh it's [PII].
[AGENT][NEUTRAL] And the policy number of the member?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It is 025.
[CUSTOMER][NEUTRAL] 93395 ML 8
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Hold on please.
[CUSTOMER][NEUTRAL] It's [PII]. It's [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility roles?
[CUSTOMER][NEUTRAL] Yes, I need to know if he has benefits with this gap plan.
[AGENT][NEUTRAL] This is a gap insurance that assists with deductible, co-pay and co-insurance for places of services that's covered under the policy. What is the place of service? Is it inpatient, outpatient, office visits?
[CUSTOMER][NEUTRAL] It's office, not office visit, it's office surgery, so he, um, he has a, an appointment today at the, um, dermatologist's office, so I need to know if because he has a deductible on his plan, any procedures rendered in the office will be the patient's responsibility. So I need to know if this gap plan will cover procedures rendered in the doctor's office.
[AGENT][NEUTRAL] So the patient policy has outpatient benefits of $1500 per calendar year and the treatment received in the office falls under the outpatient benefits and this is not a guaranteed benefit just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] So does the gap plan cover procedures in the office?
[AGENT][NEUTRAL] Yes, that's what I just explained. I just gave you benefits for outpatient benefits of $1500 per calendar year, and the treatment received in the office falls under the outpatient benefits of the $1500.
[CUSTOMER][NEUTRAL] OK, so may I have a reference number for the call?
[AGENT][NEUTRAL] We don't provide reference numbers, [PII], however, you can use my name in today's date as a reference. Is there anything else that I could assist you with today? It is [PII].
[CUSTOMER][NEUTRAL] And your name is?
[CUSTOMER][NEUTRAL] Right, what's your name?
[CUSTOMER][NEUTRAL] Can you spell that for me please?
[AGENT][NEUTRAL] [PII] and today's date. Would you like today's date?
[CUSTOMER][NEUTRAL] Yes, I would. What is it? Is it [PII] or [PII]?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Oh thank you bye bye oh thank you thank you for telling me that thanks you're welcome.
[AGENT][POSITIVE] Of [PII]. Thanks for calling APL. Have a good day. Bye.