AccountId: 011433970860
ContactId: c6fb94bf-3622-4ecc-a895-1c4b4333b059
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 143009 ms
Total Talk Time (AGENT): 79888 ms
Total Talk Time (CUSTOMER): 40686 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/c6fb94bf-3622-4ecc-a895-1c4b4333b059_20250221T13:51_UTC.wav
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[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] It's [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling regarding benefits for a patient.
[AGENT][POSITIVE] OK, it would be my pleasure to assist you with benefits today. What is a good callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you [PII].
[AGENT][NEUTRAL] And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] It is 02271385 ML 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Alright thank you and it would be my pleasure to assist you with eligibility and benefits for here in uh.
[AGENT][NEUTRAL] [PII], that policy is active with the effective date of [PII].
[AGENT][NEUTRAL] And this is a secondary policy to her primary insurance.
[AGENT][NEUTRAL] And what type of benefits are you needing?
[CUSTOMER][NEUTRAL] Uh, specialist office visit?
[AGENT][NEUTRAL] All right. Now for her office visit, her co-pay is not covered under her APL policy for the visit. She does have benefits for procedures or treatments in office, but not for the visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, what are the benefits for procedure or treatment?
[AGENT][NEUTRAL] That is under her outpatient benefit of $750. That is a per calendar day benefit.
[AGENT][NEUTRAL] And that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, so, uh, basically it pays, uh, $750 for any procedure or treatment done in the office, right?
[AGENT][NEUTRAL] That is correct, as long as it is for a sickness or injury.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] It's my pleasure to assist you with those benefits, and is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Nothing else right now.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day, uh, [PII].
[CUSTOMER][POSITIVE] Thank you. Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.